PURPOSE This study evaluated sacral neuromodulation's effectiveness for managing refractory neuropathic lower urinary tract dysfunction in children and adolescents. METHODS Twenty-five children and adolescents underwent peripheral nerve evaluation test phase of sacral neuromodulation at our center. Thirteen (seven boys and six girls) cases suffered from neuropathic lower urinary tract dysfunction refractory to the maximum medical treatment. The test was done with temporary wire in all patients. Patients with more than 50% improvement in symptoms were chosen for the second stage of implantation of quadripolar tined lead and implantable pulse generator. Bowel transit symptoms were recorded before and after the surgery. RESULTS Eight patients (61.53%; five boys and three girls) had positive responses to the peripheral nerve evaluation test phase. They underwent implantation of permanent quadripolar tined lead and implantable pulse generator. The etiologies were lumbosacral myelomeningocele, occult spina bifida, partial sacral agenesis and incomplete spinal cord injury. Positive clinical response (> 50% improvement in symptoms) was achieved in seven (85%) at a mean follow-up of 14.25 months. Three patients became capable to stop clean intermittent catheterization (P =0.125). The 24-h pad test decreased from 484 to 78 g from before to after the surgery (P =0.043). CONCLUSION This clinical study on a small sample size of children and adolescents demonstrates positive results in short-term follow-up. However, as the procedure is still not approved officially, multicenter studies with more patients can prove the safety and efficacy of sacral neuromodulation in long term among this special group of patients.

中文翻译：

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先天性腰s部和创伤性脊髓缺损伴神经源性下尿路症状的神经调节：儿童和青少年的单中心经验。

目的本研究评估了neuro神经调节治疗儿童和青少年难治性神经性下尿路功能障碍的有效性。方法25例儿童和青少年在我们中心接受了neuro神经调节的周围神经评估测试阶段。十三例（七个男孩和六个女孩）患有神经性下尿路功能障碍，无法接受最大程度的药物治疗。所有患者均使用临时金属丝进行测试。选择症状改善超过50％的患者进行四极镀锡铅和可植入脉冲发生器的第二阶段植入。在手术前后记录肠道转运症状。结果8例（61.53％; 5个男孩和3个女孩）对周围神经评估测试阶段反应良好。他们接受了永久性四极镀锡铅和可植入脉冲发生器的植入。病因是腰s部髓鞘膜膨出，隐匿性脊柱裂、,部发育不全和脊髓损伤不完全。平均随访14.25个月，有7例（85％）获得了积极的临床反应（症状改善> 50％）。三名患者能够停止清洁的间歇性导管插入术（P = 0.125）。从术前到术后24小时垫试验从484克降至78克（P = 0.043）。结论这项关于小样本儿童和青少年的临床研究证明了短期随访的积极结果。但是，由于该程序仍未获得正式批准，