Sacral Nerve Stimulation

  • Jean Michel Guys
  • Mirna Haddad
  • Denis Planche

23.6 Conclusion

Sacral nerve stimulation (interstim therapy) in children seems to be a promising new therapeutic modality. Implant placement is minimally invasive, non-destructive, and reversible. Use in children with neurogenic bladder is only at the beginning stages. Our results are encouraging, but the study population was too small, and the lesions were probably too severe to demonstrate the benefit of this therapy. A French multi-center study, including more patients with less severe lesions, has been under way since April 2005.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Guys JM, Aubert D: La vessie neurologique de l’enfant. Sauramps Medical ed. 280 p, 1998.Google Scholar
  2. 2.
    Krishna A, Gough DCS. Evaluation of augmentation cystoplasty in childhood with reference to vesico-ureteric reflux and urinary infection. Br J Urol 1994;74:465–68.PubMedCrossRefGoogle Scholar
  3. 3.
    Brindley GS. Experiments directed towards a prosthesis which controls the bladder and the external sphincter from a single site of stimulation. Proc Biological Engineering Society, 46th Meeting, Liverpool, England, 1972.Google Scholar
  4. 4.
    Brindley GS, Polkey CE, Rushton DN. Sacral anterior root stimulation for bladder control in paraplegia. Paraplegia 1982;20:365–68.PubMedGoogle Scholar
  5. 5.
    Van Kerrebroeck PhEV, Koldewijn EL, Wijkstra H, Debruyne FMJ. Intradural sacral rhizotomies and implantation of an anterior sacral root stimulator in the treatment of neurogenic bladder dysfunction after spinal cord injury. World J Urol 1991;9:126–30.CrossRefGoogle Scholar
  6. 6.
    Tanagho EA, Schmidt RA, Orvis BR. Neural stimulation for control of voiding dysfunction: a preliminary report in 22 patients with serious neuropathic voiding disorders. J Urol 1989;142:340–43.PubMedGoogle Scholar
  7. 7.
    Habib HN. Experiences and recent contributions in sacral nerve stimulation for both human and animal. Br J Urol 1967;39:73.PubMedCrossRefGoogle Scholar
  8. 8.
    Chancelor MB, Chartier-Kastler EJ. Principles of sacral nerve stimulation for the treatment of bladder and ureteal sphincter dysfunctions. Neuromodulation 2000;3:15–26.Google Scholar
  9. 9.
    de Groat WC, Theobald RJ. Reflex activation of sympathetic pathways to vesical smooth muscle and para-sympathetic ganglia by electrical stimulation of vesical afferents. J Physiol 1976;259:223–37.PubMedGoogle Scholar
  10. 10.
    Thon WF, Baskin LS, Jonas U, Tanagho EA, Schmidt EA. Surgical principles of sacral foramen electrode implantation. World J Urol 1991;9:133–37.Google Scholar
  11. 11.
    Bosch JL, Groen J. Neuromodulation: urodynamic effects of sacral (S3) spinal nerve stimulation in patients with detrusor instability or detrusor hyperflexia. Behav Brain Res 1998;92:141–50.PubMedCrossRefGoogle Scholar
  12. 12.
    Spinelli M, Bertapelle P, Cappellano F, Zanollo A, Carone R, Catanzaro F, Giardello G. Chronic sacral neuromodulation in patients with lower urinary tract symptoms: results from a national register. J Urol 2001;166:541–45.PubMedCrossRefGoogle Scholar
  13. 13.
    Thon WF, Baskin LS, Jonas U, Tanagho EA, Schmidt RA. Neuromodulation of voiding dysfunction and pelvic pain. World J Urol 1991;9:138–41.Google Scholar
  14. 14.
    Dasgupta R, Wiseman OJ, Kitchen N, Fowler CJ. Long-term results of sacral neuromodulation for women with urinary retention. BJU Int 2004;94:335–37.PubMedCrossRefGoogle Scholar
  15. 15.
    Hassouna MM, Siegel SW, Nyeholt AA, Elhilali MM, Van Kerrebroeck PE, Das AK, Gajewski J, Janknegt RA, Rivas DA, Dijkema H, Miram DF, Oleson KA, Schmidt RA. Sacral neuromodulation in the treatment of urgency frequency symptoms: a multicenter study on efficacy and safety. J Urol 2000;163:1849–54.PubMedCrossRefGoogle Scholar
  16. 16.
    Mahfooz AB, Elmayergi N, Abdelhady M, Wang Y, Hassouna M. Parameters of successful sacral root neuromodulation of the pelvic floor: a retrospective study. Can J Urol 2004;11:2303–8.PubMedGoogle Scholar
  17. 17.
    Ruffion A, Dembele D, N’Goi C, Morel-Journel N, Leriche A. Sacral root neuromodulation for the treatment of urinary incontinence reported to detrusor hyperactivity. Neurochirugie 2003;49:377–82.Google Scholar
  18. 18.
    Capito D, Ausania F, Esposito E, Bruni R, Arullani A. Sacral nerve neuromodulation improves physical, psychological and social quality of life in patients with fecal incontinence. Tech Coloprocto 2002;6:147–52.CrossRefGoogle Scholar
  19. 19.
    Elhilali MM, Khaled SM, Kashiwabara T, Elzayat E, Corcos J. Sacral neuromodulation: long-term experience of one center. Urology 2005;65:1114–17.PubMedCrossRefGoogle Scholar
  20. 20.
    Guys JM, Haddad M, Planche D, Torre M, Louis-Borrione C, Breaud J. Sacral neuromodulation for neurogenic bladder dysfunction in children. J Urol 2004;172:1673–76.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2006

Authors and Affiliations

  • Jean Michel Guys
    • 1
  • Mirna Haddad
    • 2
  • Denis Planche
    • 3
  1. 1.Department of Pediatric SurgeryLa Timâe Children’s HospitalMarseilleFrance
  2. 2.Department of Pediatric SurgeryLa Timâe HospitalMarseilleFrance
  3. 3.Electrophysiological DepartmentHopital de la ConceptionMarseilleFrance

Personalised recommendations