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Sacral Neuromodulation in Children: Experiencie in Colombia

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SACRAL NEUROMODULATION IN CHILDREN: EXPERIENCE IN COLOMBIA

 Lopera Toro Adrián Ramiro (1), Serna Higuita Lina Maria (2), Nieto Ríos John Fredy(3), Serrano Gayubo Ana Katherina(4)Castaño Botero Juan Carlos (5)

 

(1)   Residente Urología. Universidad CES,; (2)   Nefróloga infantil. Hospital Pablo Tobón Uribe; (3)   Nefrologo Hospital Pablo Tobon Uribe; (4)   Nefrologa Infantil, Universidad de Antioquia; (5)   Urólogo. Hospital Pablo Tobón Uribe

 

Introduction: Neuromodulation exists as a treatment for dysfunctional elimination syndromes since 1997, however, its applications in the pediatric population appear 10 years later, since then several series have reported the usefulness of Interstim in handling both functional urinary and gastrointestinal disorders.

 Materials and Methods: This is a retrospective study, we present the experience we currently have in the management of children with both gastrointestinal and urinary functional disorders.  All of the patients have had no response to medical management and in whom sacral neuromodulation is the only treatment option.

 Results: Interstim Device implantation was performed in 10 children between 2008 and 2013, with a mean follow-up of 11 months. That procedure was performed by a single urologist. Indications of the device were evaluated, all patient had failure with previous treatments, the urodynamic behavior of each patient , and questions about its impact on quality of life were performed. The primary end point was to evaluate the improvement of the symptoms, these improved 100 % during fist stage and 90 % during definitve procedure (second stage), few side effects were seen and all patients interrogated were satisfied.

 Conclusion: Neuromodulation in children with sacral root stimulation is a safe and effective procedure in selected patients and performed by properly trained personnel.

 Key words: sacral neuromodulation, dysfunctional elimination syndrome, gastrointestinal disorders, quality of life