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Sacral Neuromodulation in Children

  • Ilaria Jansen
  • Ana Ludy Lopes Mendes
  • Francesco Cappellano
  • Mario De Gennaro
  • Giovanni Mosiello
Chapter
Part of the Urodynamics, Neurourology and Pelvic Floor Dysfunctions book series (UNPFD)

Abstract

Stimulation of the parasympathetic nerves via the sacral micturition centre travels in the pelvic nerve, resulting in contraction of the detrusor muscle and relaxation of the sphincter facilitating micturition. Different modalities of neuromodulation have been used in children, and the level of interest for treating bladder-bowel dysfunction is high with SNM over time. In adult patients invasive SNM using electrode in third sacral foramina is largely utilized while is limited in paediatrics. Indications still controversial, and the third sacral (S3) nerve root remains the main access point used for neuromodulation. Nowadays this treatment is considered as a second- or third-line treatment for patients when conservative or less-invasive treatment has failed. Moreover some studies in literature have demonstrated their safety and effectiveness in well-selected cases as a reversible and mini-invasive treatment for neurogenic bladder, demonstrating an improvement on urodynamic parameters such us the bladder capacity or bladder compliance after SNM implantation and even an improvement on bowel dysfunction.

Keywords

Sacral neuromodulation Neurogenic bladder Neurogenic bowel Nonobstructive urinary retention Children Lower urinary tract dysfunction Urodynamics Bowel bladder dysfunction Constipation Spina bifida 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ilaria Jansen
    • 1
    • 2
  • Ana Ludy Lopes Mendes
    • 3
  • Francesco Cappellano
    • 4
    • 5
  • Mario De Gennaro
    • 6
  • Giovanni Mosiello
    • 7
  1. 1.Department of UrologyAMCAmsterdamNetherlands
  2. 2.Department of Biomedical Engineering and PhysicsAMCAmsterdamNetherlands
  3. 3.Division of Urology, Surgery for Continence and Neuro-UrologyBambino Gesù Pediatric HospitalRomeItaly
  4. 4.Department of UrologistNation HospitalAbu DhabiUAE
  5. 5.Department of Neuro-UrologyVerona UniversityVeronaItaly
  6. 6.Robotic and Urology UnitBambino Gesù Pediatric HospitalRomeItaly
  7. 7.Pediatric NeuroUrology Research and ClinicBambino Gesù Pediatric HospitalRomeItaly

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