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.
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Jansen, I., Mendes, A.L.L., Cappellano, F., De Gennaro, M., Mosiello, G. (2018). Sacral Neuromodulation in Children. In: Mosiello, G., Del Popolo, G., Wen, J., De Gennaro, M. (eds) Clinical Urodynamics in Childhood and Adolescence. Urodynamics, Neurourology and Pelvic Floor Dysfunctions. Springer, Cham. https://doi.org/10.1007/978-3-319-42193-3_28
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