WOFAPS 2025 8th World Congress of Pediatric Surgery

Zheming Xu

Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center

Objective: To analyze the efficacy of sacral neuromodulation (SNM) in the treatment of pediatric NLUTD, and to explore the application value of SNM in children with NLUTD

Methods: Patients with NLUTD who underwent SNM treatment in Children's Hospital of Zhejiang University School of Medicine from May 2020 to July 2025 were included. The treatment effect was analyzed by ICCS recommended micturition dysfunction symptom score, pediatric urinary incontinence quality of life score, urinary ultrasound, and urodynamic indicators (compliance, FD, MCC, DLPP).

Results: A total of 20 children with NLUTD underwent SNM phase 1 electrode implantation (1 case used a new generation of SureScan- whole-body MRI compatible electrode), including 11 males and 9 females. There were 15 cases of spinal cord hypoplasia (including tethered cord, myelomeningocele, spinal lipoma and coccygeal degeneration syndrome), 3 cases of congenital anal atresia, 1 case of sacrococcygeal tumor, and 1 case of non-neurogenic neurogenic bladder. Age 5-17 years old at the time of surgery. A total of 3 children did not receive the second-stage stimulator implantation, of which 2 children did not meet the expected treatment effect during the experience period (1 case completely removed the electrode, 1 case retained the electrode to cut the outer part of the lead), and 1 case could not be implanted in the second stage due to the formation of subcutaneous abscess after postoperative infection. 17 children successfully completed the implantation of the second-stage stimulator. Urinary storage symptoms (urgency, frequency/incontinence) and/or voiding symptoms (non-obstructive urinary retention/straining to urinate) were significantly improved by evaluations via OABSS score, 24-hour voiding diary, PPBC-C score, AUA-SI-QOL score, SAS score and ultrasound (post-residual urine).

Conclusion: NLUTD in children has a significant impact on the physical and mental health of children. As an effective third-line treatment option, SNM has shown significant results in improving symptoms and quality of life in children. However, due to the heterogeneity of NLUTD in children and the complexity of SNM techniques, treatment needs to be individualized and fully considered for each patient.