Prospective evaluation of sacral nerve modulation in children with validated questionnaires

Area of Science:

• Pediatric Urology
• Neuromodulation
• Quality of Life Assessment

Background:

• Refractory urinary dysfunction in children presents significant challenges.
• Sacral neuromodulation (SNM) is an emerging treatment option for pediatric patients.
• Validated outcome measures are crucial for evaluating SNM efficacy in this population.

Purpose of the Study:

• To prospectively evaluate the efficacy of sacral neuromodulation in pediatric patients with refractory urinary dysfunction.
• To assess changes in quality of life and bladder dysfunction using validated questionnaires.
• To determine the durability of treatment effects at short-term follow-up.

Main Methods:

• Prospective enrollment of 14 pediatric patients undergoing sacral neuromodulation.
• Administration of PedsQL™ 4.0 and Vancouver Nonneurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome (NLUTD/DES) questionnaires preoperatively and postoperatively.
• Statistical analysis using the Wilcoxon matched pairs test (p <0.05 significance).

Main Results:

• Significant improvements observed in psychosocial quality of life (p=0.02) and total quality of life scores (p=0.006).
• Marked reduction in NLUTD/DES scores (p<0.001), indicating decreased bladder dysfunction.
• Outcomes remained significant at one month postoperatively; no infections reported.

Conclusions:

• Sacral neuromodulation demonstrates significant efficacy in improving quality of life and reducing urinary dysfunction in pediatric patients.
• The observed benefits are durable at one month, suggesting sustained improvement.
• Further prospective studies with longer follow-up are warranted to solidify evidence for SNM in pediatric populations.