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Sacral neuromodulation for neurogenic bladder dysfunction in children
J M Guys1, M Haddad, D Planche
1Département de Chirurgie Pédiatrique, Hôpital d'enfants de la Timone, Marseille, France. jmguys@ap-hm.fr
The Journal of Urology
|September 17, 2004
Summary
Sacral neuromodulation (SNM) shows potential for pediatric neurogenic bladder, but results were not significantly better than conventional treatment in this study. Further multicenter research is needed to confirm SNM
Area of Science:
- Pediatric Urology
- Neurology
- Biomedical Engineering
Background:
- Neurogenic bladder dysfunction in children often leads to urinary incontinence.
- Current management strategies may have limitations.
- Sacral neuromodulation (SNM) is an emerging therapeutic option.
Purpose of the Study:
- To prospectively evaluate the benefits of sacral neuromodulation (SNM) in children with neurogenic bladder.
- To compare SNM with conventional treatment for urinary incontinence.
- To assess urodynamic parameters and clinical outcomes.
Main Methods:
- A prospective randomized controlled study included 42 children (ages 5-21) with neurogenic bladder and incontinence.
- Patients were randomized to conventional treatment or SNM.
- Outcomes were assessed over 12 months via clinical exams, voiding diaries, and urodynamics.
Main Results:
- No significant difference in overall outcomes between SNM and conventional groups.
- SNM group showed improved leak point pressure (p<0.05) and transient improvements in bladder capacity and compliance.
- Some patients in the SNM group reported improved bowel function and reduced infections; 3 required revision surgery.
Conclusions:
- SNM is a minimally invasive, reversible option for pediatric neurogenic bladder.
- While some benefits were observed, SNM did not show statistically significant superiority over conventional treatment in this cohort.
- Larger multicenter studies are recommended to further evaluate SNM efficacy in children.