Sacral Neuromodulation in Children

Sacral neuromodulation (SNM) has emerged as a treatment option for refractory lower urinary tract and bowel dysfunction in children. SNM is typically reserved for a select population of children who have failed an extended period of behavioral modification, biofeedback, and pharmacologic therapy. The surgical techniques for SNM in children are analogous to those in adults and include both one- and two-stage procedures as well as a peripheral nerve evaluation with the InterStim® system (Medtronic, Minneapolis, MN). Most studies have observed not only an improvement in symptoms and quality of life in children undergoing SNM for non-neurogenic and neurogenic lower urinary tract dysfunction but also a much higher reoperative rate than in adults. Further high-quality research is necessary to corroborate the results of earlier studies and to better define the indications for SNM in children.