The Evidence for Implantable Sacral Neuromodulation in Pediatric Voiding Dysfunction

Author:

Malallah Mariam,Cameron Anne,Sack Bryan

Abstract

Abstract Purpose of Review The purpose of this review is to evaluate the evidence regarding the efficacy and safety of implantable sacral neuromodulation (SNM) in pediatric patients with voiding dysfunction. The aim is to address the lack of substantial supporting data for SNM use in pediatric populations and provide insights into its potential as a treatment option. Recent Findings Recent research indicates that SNM can be an effective treatment for pediatric voiding dysfunction when conventional therapies fail. A systematic review of eight studies published between 2008 and 2021, involving 427 pediatric patients, revealed promising outcomes. These included a 68% improvement rate in urinary symptoms, with 39% experiencing complete resolution. Urodynamic improvements were also noted, with reductions in detrusor pressure, uninhibited detrusor contractions, and postvoid residual volume. However, complications such as lead issues, device migration or erosion, pain, and IPG replacement were observed in a notable percentage of cases, necessitating reoperation in some instances. Summary In conclusion, implantable SNM emerges as a potentially effective treatment for pediatric voiding dysfunction, improving urinary symptoms and quality of life. However, the presence of complications underscores the importance of careful risk-benefit assessment for individual patients. Further research is warranted to address varying success rates and complications, emphasizing the need for improved trial quality in this field. The findings of this review highlight the potential impact of SNM in pediatric populations and underscore the need for continued investigation and refinement of this therapeutic approach.

Funder

Royal College of Surgeons in Ireland

Publisher

Springer Science and Business Media LLC

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