Neuromodulation for Treatment of Refractory Non-neurogenic Lower Urinary Tract Symptoms in Children: an Overview

AbstractPurpose of ReviewThis review will address current literature on electrical nerve stimulation in the pediatric population for the treatment of non-neurogenic lower urinary tract symptoms. The following therapies will be discussed: parasacral transcutaneous electrical nerve stimulation (TENS), transcutaneous posterior tibial nerve stimulation (TCPTNS), and implantable sacral neuromodulation.Recent FindingsThus far, all studies have demonstrated safety similar to the adult population. Although few studies have been performed in children, TENS and TCPTNS have favorable enough results to justify offering as treatment for patients who would like to avoid lead implantation. Sacral neuromodulation has shown some promising results in recent large-cohort studies with quality-of-life assessments, particularly in patients with urinary incontinence, overactive bladder symptoms, and constipation. However, device malfunction and high reoperation rates remain problematic.SummaryElectrical nerve stimulation in the carefully selected pediatric patient can be a safe and viable option. Family should be counseled on its off-label use and risks of complications that are unique to this population. Future studies should focus on standardizing preoperative assessment pathways, identifying predictors of postoperative success and exploring the durability of effects.
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research