Pediatric sacral nerve stimulator explanation due to complications or cure: a survival analysis

Rensing, Adam; Szymański, Konrad M.; Dunn, Sally; King, Shelly; Cain, Mark P.; Whittam, Benjamin

doi:10.1016/j.jpurol.2018.10.010

Cited by 10 publications

(3 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study reinforces the expectations raised by Rensing et al, who demonstrated the possibility of discontinuing SNM under certain conditions in pediatric patients (median age at implantation of SNM was 10.1 years), as a possible strategy for the cure. In particular, in children with at least 2 years of SNM use and good treatment response, they showed that the chance of long-term successful removal of SNM is directly proportional to its duration of use ( 24 ). Our case shows this possibility also in the adult population as well.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Sacral Nerve Root Pelvic Neural Retraining, With Long-Term Sustainability After the Device Explantation

Vassiliu¹,

Patoulis²,

Naar³

et al. 2021

Front. Rehabilit. Sci.

View full text Add to dashboard Cite

Introduction: Sacral-Nerve-Neuromodulation (SNM) is an effective treatment increasingly used in patients with urinary (UI) and fecal incontinence (FI). The way it acts in the body at its full potential have not yet been elucidated. The authors review the literature on SNM and the way it possibly works, relating it to a case with an unusually favorable outcome.Case Presentation: A female presented with UI and FI. Operated for meningocele as a neonate. It the age of 5 bilateral Cohen ureter reimplantation performed for persistent urinary infections due to vesicourethral reflux. At the age of 13, she started complaining about UI associated with a hyper functional detrusor muscle. After a diary incontinence evaluation with a standardized questionnaire, SNM was applied at the age of 18 and was retained for 4 years. She was re-evaluated with a yearly follow-up.Results: The patient retained the positive effect of SNM even after its removal and in addition showed signs of improvement. The patient developed the sensation of fillingness of the bladder and the rectum, which she never had before the SNM implantation, sensation which she retained 29 months after (last follow-up) device removal, allowing her to control her voids.Discussion: The modern literature hypothesis that SNM contributes to the plasticity of the nerves through the stimulated area is supported by the present case, in which the SNM effect remained and led to improvements even after its removal. Device settings are presented as they may correlate with the result. This reinforces and expands the frontiers of SNM application and research.

show abstract

Section: Discussionmentioning

confidence: 99%

Case Report: Sacral Nerve Root Pelvic Neural Retraining, With Long-Term Sustainability After the Device Explantation

Vassiliu¹,

Patoulis²,

Naar³

et al. 2021

Front. Rehabilit. Sci.

View full text Add to dashboard Cite

show abstract

“…For example, implantable sacral neuromodulation involves placing an implantable pulse generator, electrodes, and a battery. In children, this procedure requires administering general anesthesia twice, and if the treatment is ineffective, a third procedure may be necessary for device explantation ( 5 ). Transcutaneous sacral nerve stimulation is a corollary treatment that does not need general anesthesia or an implantable device ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

At-home use of parasacral transcutaneous electrical nerve stimulation for pediatric voiding dysfunction: a randomized controlled trial to assess its safety and feasibility

Malhotra,

Siegal,

Lange

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

IntroductionTreating pediatric voiding dysfunction involves behavioral changes that require significant time or medications that are often avoided or discontinued due to side effects. Using parasacral transcutaneous electrical nerve stimulation (PTENS) has shown to have reasonable efficacy, but the safety and feasibility of its off-label use for pediatric voiding dysfunction are not well-established. Concerns have also been raised over treatment adherence. In-home therapy might improve adherence compared with office-based therapy; however, no studies have evaluated in-home feasibility to date. This study aims to assess the safety and feasibility of off-label use of PTENS for pediatric voiding dysfunction.Materials and methodsA single-institution prospective, randomized controlled study was conducted from March 2019 to March 2020. Participants aged 6–18 years diagnosed with voiding dysfunction, overactive bladder, or urinary incontinence were eligible for the study. Those with known neurologic disorders, implanted electrical devices, anatomic lower urinary tract abnormality, and recurrent urinary tract infections and those taking bladder medications were excluded. Children with primary monosymptomatic nocturnal enuresis were also excluded due to previous work suggesting a lack of efficacy. Participants were randomly assigned to receive 12 weeks of urotherapy alone (control) or urotherapy plus at-home PTENS treatment. Families were contacted weekly to assess for adverse events (AEs) and treatment adherence. The primary and secondary outcomes were safety, defined as the absence of AEs and treatment adherence, respectively.ResultsA total of 30 eligible participants were divided into two groups, with 15 participants in each arm. The median age was 9.4 years (interquartile range: 7.7–10.6). In total, 60% were male. Baseline demographics and urotherapy compliance were similar between the two groups. With PTENS use, two AEs were reported, including mild pruritus at the pad site and discomfort when removing pads, while no AEs were noted in the control group. In total, 60% of patients completed three 30-min sessions per week, and all participants were able to complete treatment sessions for at least 10 weeks, involving 30 min of PTENS treatment each time.ConclusionThis randomized controlled study confirms that at-home use of PTENS is feasible with reasonable treatment adherence and minimal AEs. Future collaborative, multi-institutional studies may better determine the efficacy of this treatment modality.

show abstract

“…9 This treatment also appears to be time limited as device explanation for cure occurs with increasing likelihood after 2 years. 10 There is currently a multi-institutional study ongoing (Sacral Neuromodulation Alliance for Pediatric Patients) to further evaluate this modality.…”

mentioning

confidence: 99%

Pediatric Dysfunctional Elimination: Cars and Continence—Is Electricity the Future?

Pope

2021

Journal of Urology

View full text Add to dashboard Cite

Pediatric sacral nerve stimulator explanation due to complications or cure: a survival analysis

Abstract: ConclusionSacral neuromodulation is a safe, viable option for the pediatric patient with refractory bladder dysfunction. Furthermore, SNM explantation for cure is an option with increasing likelihood after 2 years.

Cited by 10 publications

References 22 publications

Case Report: Sacral Nerve Root Pelvic Neural Retraining, With Long-Term Sustainability After the Device Explantation

Case Report: Sacral Nerve Root Pelvic Neural Retraining, With Long-Term Sustainability After the Device Explantation

At-home use of parasacral transcutaneous electrical nerve stimulation for pediatric voiding dysfunction: a randomized controlled trial to assess its safety and feasibility

Pediatric Dysfunctional Elimination: Cars and Continence—Is Electricity the Future?

Contact Info

Product

Resources

About