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SACRAL NEUROMODULATION FOR NEUROGENIC BLADDER DYSFUNCTION IN CHILDREN

2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 4 Part 2 Linguagem: Inglês

10.1097/01.ju.0000138527.98969.b0

1527-3792

Jean-Michel Guys, M. Haddad, D Planche, Michele Torre, C. Louis‐Borrione, Jean Bréaud,

Pain Management and Treatment

No AccessJournal of UrologyNeurogenic Bladder1 Oct 2004SACRAL NEUROMODULATION FOR NEUROGENIC BLADDER DYSFUNCTION IN CHILDREN J.M. GUYS, M. HADDAD, D. PLANCHE, M. TORRE, C. LOUIS-BORRIONE, and J. BREAUD J.M. GUYSJ.M. GUYS , M. HADDADM. HADDAD , D. PLANCHED. PLANCHE , M. TORREM. TORRE , C. LOUIS-BORRIONEC. LOUIS-BORRIONE , and J. BREAUDJ. BREAUD View All Author Informationhttps://doi.org/10.1097/01.ju.0000138527.98969.b0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report a prospective randomized controlled study to evaluate the possible benefits of sacral neuromodulation (SNM) for the management of neurogenic bladder dysfunction in children. Materials and Methods: We included in the study subjects between the ages of 5 and 21 years presenting with urinary incontinence due to neurogenic bladder. Before study inclusion all previous treatment was discontinued. Patients were randomly divided into the control group treated conventionally and the implant group treated with SNM. Treatment outcome was compared every 3 months for a minimum of 12 months based on clinical examination, voiding diary and urodynamic evaluation. Results: A total of 26 boys and 16 girls with a mean age of 11.9 years were enrolled in this study. There were 21 patients in each group. The main underlying etiology was spina bifida. The 2 groups were comparable with regard to sex, age and urodynamic variables. Total disappearance of urinary leakage was observed in 1 patient who underwent implantation but he still required intermittent catheterization. Comparison of urodynamic variables disclosed no significant statistical difference except with regard to functional bladder capacity which was better in the control group and the leak point pressure which was better in the implant group (p <0.05). Evaluation of interindividual variations in the implant group revealed significant improvement in compliance and functional bladder capacity at 6 and 9 months but not at 12 months. Nine patients in the implant group reported improvement in intestinal transit, 5 total disappearance of urinary infection and 6 persistent sensation of a full bladder. No patient in the control group reported any improvement. Revision surgery was required in 3 cases due to lead migration, faulty connection and wound infection. Conclusions: SNM is a promising new therapeutic modality. Implant placement is minimally invasive, nondestructive and reversible. Use in children with neurogenic bladder has not been previously reported. Although some improvement was noted in patients treated with SNM, the difference with the control group was not significant. A larger multicenter study is warranted to evaluate SNM. References 1 : La vessie neurologique de l'enfant. Sauramps Medical1998; : 280. 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Google Scholar © 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByMason M, Stephany H, Casella D, Clayton D, Tanaka S, Thomas J, Adams M, Brock J and Pope J (2016) Prospective Evaluation of Sacral Neuromodulation in Children: Outcomes and Urodynamic Predictors of SuccessJournal of Urology, VOL. 195, NO. 4 Part 2, (1239-1244), Online publication date: 1-Apr-2016.Stephany H, Juliano T, Clayton D, Tanaka S, Thomas J, Adams M, Brock J and Pope J (2013) Prospective Evaluation of Sacral Nerve Modulation in Children with Validated QuestionnairesJournal of Urology, VOL. 190, NO. 4S, (1516-1522), Online publication date: 1-Oct-2013.Groen L, Hoebeke P, Loret N, Van Praet C, Van Laecke E, Ann R, Vande Walle J and Everaert K (2018) Sacral Neuromodulation with an Implantable Pulse Generator in Children with Lower Urinary Tract Symptoms: 15-Year ExperienceJournal of Urology, VOL. 188, NO. 4, (1313-1318), Online publication date: 1-Oct-2012.Dwyer M and Reinberg Y (2018) The Dysfunctional Elimination Syndrome in Children—Is Sacral Neuromodulation Worth the Trouble?Journal of Urology, VOL. 188, NO. 4, (1076-1077), Online publication date: 1-Oct-2012.De Gennaro M, Capitanucci M, Mosiello G and Zaccara A (2018) Current State of Nerve Stimulation Technique for Lower Urinary Tract Dysfunction in ChildrenJournal of Urology, VOL. 185, NO. 5, (1571-1577), Online publication date: 1-May-2011.Clark C, Ngo T, Comiter C, Anderson R and Kennedy W (2011) Sacral Nerve Stimulator Revision Due to Somatic GrowthJournal of Urology, VOL. 186, NO. 4S, (1576-1580), Online publication date: 1-Oct-2011.Haddad M, Besson R, Aubert D, Ravasse P, Lemelle J, El Ghoneimi A, Moscovici J, Hameury F, Baumstarck-Barrau K, Hery G and Guys J (2018) Sacral Neuromodulation in Children With Urinary and Fecal Incontinence: A Multicenter, Open Label, Randomized, Crossover StudyJournal of Urology, VOL. 184, NO. 2, (696-701), Online publication date: 1-Aug-2010.Routh J and Reinberg Y (2018) Editorial CommentJournal of Urology, VOL. 184, NO. 2, (689-689), Online publication date: 1-Aug-2010.Roth T, Vandersteen D, Hollatz P, Inman B and Reinberg Y (2018) Sacral Neuromodulation for the Dysfunctional Elimination Syndrome: A Single Center Experience With 20 ChildrenJournal of Urology, VOL. 180, NO. 1, (306-311), Online publication date: 1-Jul-2008.Gurocak S, De Gier R and Feitz W (2018) Bladder Augmentation Without Integration of Intact Bowel Segments: Critical Review and Future PerspectivesJournal of Urology, VOL. 177, NO. 3, (839-844), Online publication date: 1-Mar-2007.Lemelle J, Guillemin F, Aubert D, Guys J, Lottmann H, Lortat-Jacob S, Moscovici J, Mouriquand P, Ruffion A and Schmitt M (2018) A Multicenter Evaluation of Urinary Incontinence Management and Outcome in Spina BifidaJournal of Urology, VOL. 175, NO. 1, (208-212), Online publication date: 1-Jan-2006.Humphreys M, Vandersteen D, Slezak J, Hollatz P, Smith C, Smith J and Reinberg Y (2018) Preliminary Results of Sacral Neuromodulation in 23 ChildrenJournal of Urology, VOL. 176, NO. 5, (2227-2231), Online publication date: 1-Nov-2006. Volume 172Issue 4 Part 2October 2004Page: 1673-1676 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsbladder, neurogenicchildsacrumMetricsAuthor Information J.M. GUYS More articles by this author M. HADDAD More articles by this author D. PLANCHE More articles by this author M. TORRE More articles by this author C. LOUIS-BORRIONE More articles by this author J. BREAUD More articles by this author Expand All Advertisement PDF DownloadLoading ...