Mp50-19 Sacral Neuromodulation in Bladder and Bowel Dysfunction: Early Insights From the First Canadian Pediatric Cohort

You have accessJournal of UrologyPediatrics III (MP50)1 May 2024MP50-19 SACRAL NEUROMODULATION IN BLADDER AND BOWEL DYSFUNCTION: EARLY INSIGHTS FROM THE FIRST CANADIAN PEDIATRIC COHORT Dean Elterman, Roseanne Ferreira, Natasha Brownrigg, Mandy Rickard, Max Freeman, Abby Varghese, Michael Chua, Armando Lorenzo, and Joana Dos Santos Dean EltermanDean Elterman , Roseanne FerreiraRoseanne Ferreira , Natasha BrownriggNatasha Brownrigg , Mandy RickardMandy Rickard , Max FreemanMax Freeman , Abby VargheseAbby Varghese , Michael ChuaMichael Chua , Armando LorenzoArmando Lorenzo , and Joana Dos SantosJoana Dos Santos View All Author Informationhttps://doi.org/10.1097/01.JU.0001008684.57262.97.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: As the prevalence of refractory bladder and bowel disease (BBD) persists, innovative solutions are paramount in pediatric urological care.This study aims to present the inaugural Canadian experience using sacral neuromodulation (SNM) as therapeutic option for children with refractory BBD. METHODS: Patients3 months of optimized combined medical therapy. Two-stage SNM implantation was executed with a minimum 2-week Stage-1 trial. Functional outcomes and complication rates were measured following institutional protocols. RESULTS: Six patients completed Stage-2 implantation at median age of 10.8 years (range 8.2-18). Indications included one patient with primary bladder symptoms – urinary incontinence (UI) -, four mixed dysfunction - UI, Fecal incontinence (FI) and one FI (Table 1). Median baseline Dysfunctional Voiding Scoring System (DVSS) score was 12.5 (10-22). Medication utilization reduced; At 6 months follow-up, only one patient required adjunct bladder medication. Median DVSS at 1-year follow-up was 5.5 (0-7). Symptomatic resolution was noted in 3 patients at 6 months, sustained over 1-year. Early surgical complications were reported in 1 (infection) and late complications in 3 (lead fracture, battery depletion, non-traumatic malfunction), requiring SNM reimplantation at a median of 37.5 months (range 36-49) post-implantation. CONCLUSIONS: SNM offers promising results for refractory pediatric BBD in Canada. The significant improvement in symptoms highlights the treatment's potential which must be balanced against the high need for revision detected at 3 years. This study establishes the feasibility of introducing SNM for selected refractory pediatric patients with BBD. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e839 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Dean Elterman More articles by this author Roseanne Ferreira More articles by this author Natasha Brownrigg More articles by this author Mandy Rickard More articles by this author Max Freeman More articles by this author Abby Varghese More articles by this author Michael Chua More articles by this author Armando Lorenzo More articles by this author Joana Dos Santos More articles by this author Expand All Advertisement PDF downloadLoading ...