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Sacral nerve stimulator revision due to somatic growth
Curtis Clark1, Tin Ngo, Craig V Comiter
1Children's Hospital Medical Center of Akron, Akron, Ohio, USA.
The Journal of Urology
|August 23, 2011
Summary
Sacral nerve modulation shows efficacy in pediatric patients, but somatic growth can cause lead malfunction requiring revision surgery. Revisions are successful, restoring treatment effectiveness and ensuring continued positive outcomes.
Area of Science:
- Pediatric Urology
- Neuromodulation
- Surgical Innovation
Background:
- Sacral nerve modulation (SNM) is FDA-approved for adult voiding dysfunction.
- Limited data exists on pediatric SNM, primarily focusing on initial efficacy for neurogenic bladder and dysfunctional elimination.
Purpose of the Study:
- To describe the initial experience with sacral nerve modulation in pediatric patients.
- To investigate the phenomenon of growth spurts leading to lead malfunction and the need for revision surgery.
Main Methods:
- Retrospective chart review of pediatric patients undergoing SNM.
- Analysis of patient demographics, subjective success rates, and need for revision surgery.
- Assessment of success following revision procedures.
Main Results:
- Four pediatric patients underwent SNM with initial >50% symptom improvement.
- Three patients required five revisions due to lead malfunction, averaging 1.5 years between surgeries.
- Somatic growth of 8.1 cm between revisions was noted; efficacy returned after each revision.
Conclusions:
- Pediatric SNM demonstrates efficacy and safety comparable to adults.
- Somatic growth is a potential cause of lead malfunction, necessitating surgical revision.
- Revision surgery for lead malfunction in pediatric SNM is safe and effective, restoring therapeutic benefits.
