Preliminary Results of Sacral Neuromodulation in 23 Children

Humphreys, Mitchell R.; Vandersteen, David R.; Slezak, Jeffery M.; Hollatz, Pam; Smith, Carr J.; Smith, Janet E.; Reinberg, Yuri

doi:10.1016/j.juro.2006.07.013

Cited by 89 publications

(79 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 Bladder capacity evaluated by UDS was significantly different between neurogenic and nonneurogenic patients both initially (p < 0.0001) and after (p = 0.008) treatment with anticholinergic combination therapy. 4 Amplitude of detrusor contractions on UDS were significantly decreased by combination treatment; overall, neurogenic and non-neurogenic groups (p < 0.0001).…”

Section: Resultsmentioning

confidence: 88%

“…3 Introduction of the second anticholinergic medication. 4 If tolterodine ER 4 mg was not well tolerated as a second anticholinergic medication, it was discontinued and changed for solifenacin 5 mg. 5 If solifenacin was not well-tolerated, it was discontinued and alternative treatment was offered. Addition of medication; : change of medication.…”

Section: Methodsmentioning

confidence: 99%

“…For patients with intractable symptoms, before considering more invasive strategies, the first step is usually an increased dose of the single anticholinergic, which naturally increases the likelihood of bothersome side effects. Possible subsequent steps include intravesical instillation of oxybutynin, 1,2 sacral neuromodulation, [3][4][5] or intradetrusor injection of botulinum toxin. [6][7][8][9] Most of these methods are still under evaluation in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Double anticholinergic therapy for refractory neurogenic and non-neurogenic detrusor overactivity in children: Long-term results of a prospective open-label study

Nadeau

Schröeder

Moore

et al. 2014

CUAJ

View full text Add to dashboard Cite

Introduction: In this study, we optimize pharmacotherapy in children who failed anticholinergic monotherapy by simultaneous administration of 2 anticholinergics (oxybutynin and/or tolterodine and/or solifenacin). Methods: This report is an update of our previously published study on double anticholinergic regimen in children with refractory incontinence due to neurogenic (NDO) and non-neurogenic (DO) detrusor overactivity. Patients with an insufficient response (clinically/urodynamically) to an optimized dose of a single anticholinergic (oxybutynin or tolterodine) received a second anticholinergic (tolterodine or solifenacin), in addition to the pre-existing medication. The primary end-point was efficacy (continence) and the secondary end-points were tolerability and safety. The Patient Perception of Bladder Condition (PPBC) scale was used to rate subjective improvement of patients. Results: In total, 56 patients with DO (n = 31) or NDO (n = 25) were enrolled at a mean age of 11.4 ± 3.5 years and were followed for a minimum of 3 months. The duration of double treatment was 36 ± 23 months. Our results found that 23 patients became dry, 18 improved significantly and 15 improved moderately. Urodynamic capacity improved from 158 ± 87 mL to 359 ± 148 mL and maximal pressure of contractions decreased from 76 ± 24 to 22 ± 22 cmH 2 O (p < 0.0001). The overall success rate was 82%, since 10 patients discontinued treatment for unsatisfactory clinical response or bothersome side effects. No side effects were reported by 28 patients, mild side effects by 20, moderate side effects by 8; 2 patients withdrew from the study due to their side effects. Of the 35 patients who voided spontaneously, 8 developed post-void residuals (>20%). Conclusions: With a larger cohort and prospective follow-up, we reiterated that double anticholinergic regimen in children with DO or NDO refractory to anticholinergic monotherapy is a feasible and efficient approach.

show abstract

Section: Resultsmentioning

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Double anticholinergic therapy for refractory neurogenic and non-neurogenic detrusor overactivity in children: Long-term results of a prospective open-label study

Nadeau

Schröeder

Moore

et al. 2014

CUAJ

View full text Add to dashboard Cite

show abstract

“…Based on our experience and current literature, SNM should only be considered in children who have failed an extended period of behavioral modification, biofeedback, and pharmacologic therapy [9][10][11][12][13][14][15]. Several groups have also offered intravesical botulinum toxin A, transcutaneous electrical nerve stimulation, and percutaneous tibial nerve stimulation to this population of children but have not required them to fail these less invasive therapies prior to SNM [13,15].…”

Section: Indicationsmentioning

confidence: 99%

“…Several groups have excluded children with neurologic diseases or spinal deformities in their series [10,11,14,15]. Significant spinal deformities may complicate or even prohibit lead placement in the foramen of the third sacral spinal nerve (S3).…”

Section: Indicationsmentioning

confidence: 99%

Sacral Neuromodulation in Children

Strine

Keenan

King

et al. 2015

Curr Bladder Dysfunct Rep

View full text Add to dashboard Cite

Sacral neuromodulation (SNM) has emerged as a treatment option for refractory lower urinary tract and bowel dysfunction in children. SNM is typically reserved for a select population of children who have failed an extended period of behavioral modification, biofeedback, and pharmacologic therapy. The surgical techniques for SNM in children are analogous to those in adults and include both one-and two-stage procedures as well as a peripheral nerve evaluation with the InterStim ® system (Medtronic, Minneapolis, MN). Most studies have observed an improvement in symptoms and quality of life in children undergoing SNM for non-neurogenic and neurogenic lower urinary tract dysfunction but also a much higher reoperative rate than in adults. Further high-quality research is necessary to corroborate the results of earlier studies and to better define the indications for SNM in children.

show abstract

Maximizing the treatment of overactive bladder with sacral nerve stimulation

MacDiarmid¹

2015

Overactive Bladder

View full text Add to dashboard Cite

Preliminary Results of Sacral Neuromodulation in 23 Children

Abstract: Sacral nerve stimulation in children is an option for carefully selected patients who have failed other therapies. Our results show that sacral nerve stimulation was effective in the majority of patients with the dysfunctional elimination syndrome. However, longer followup is needed.

Cited by 89 publications

References 15 publications

Double anticholinergic therapy for refractory neurogenic and non-neurogenic detrusor overactivity in children: Long-term results of a prospective open-label study

Double anticholinergic therapy for refractory neurogenic and non-neurogenic detrusor overactivity in children: Long-term results of a prospective open-label study

Sacral Neuromodulation in Children

Maximizing the treatment of overactive bladder with sacral nerve stimulation

Contact Info

Product

Resources

About