Sacral Neuromodulation in the Management of Refractory Pediatric Lower Urinary Tract Dysfunction

Area of Science:

• Pediatric Urology
• Neuromodulation
• Lower Urinary Tract Dysfunction

Background:

• Sacral neuromodulation (SNM) is utilized for pediatric refractory lower urinary tract dysfunction (LUTD).
• Limited evidence exists on long-term outcomes of SNM in pediatric patients.

Purpose of the Study:

• To review multi-institutional outcomes of SNM in pediatric patients with refractory LUTD.
• To assess symptom improvement, quality of life, and bowel-bladder dysfunction (BBD) following SNM.
• To evaluate device complication and removal rates.

Main Methods:

• Retrospective cohort study across three children's hospitals.
• Included pediatric patients (4-18 years) with refractory LUTD undergoing SNM.
• Outcomes assessed at baseline, post-implantation, and annually.

Main Results:

• 205 pediatric patients underwent SNM; 204 completed the procedure with a median follow-up of 3.4 years.
• 178 patients (87%) reported partial or complete symptom improvement.
• Significant improvements noted in PedsQL and BBD scores (p<0.001).
• 43 patients (21%) experienced device complications; 28 (13%) had device removal due to success.

Conclusions:

• SNM provides subjective symptom improvement for the majority of pediatric patients with refractory LUTD.
• SNM is a viable treatment option for refractory LUTD in children, requiring thorough risk/benefit counseling.