NEW ORLEANS, LA USA (UroToday.com) - Dr. Matthew Mason presented a moderated poster that addressed the question of whether certain children were more prone to complications after implantation of sacral neuromodulators (SNM). Common reasons for device revision or removal include pain, device malfunction, infection, and erosion. However, the authors postulated that trauma which occurs in the context of normal childhood play and activity would comprise the majority of complications.
They reviewed the records of 30 patients (median age 8.3 years) who underwent SNM implantation between 2010-2014 and had a median follow-up of 14.8 months. Seven patients in this group required reoperations due to complications; 6 of the 7 requested replacement of the device. Five of these complications were lead breakage related to minor trauma sustained during normal play and activity (rough-housing with siblings, falling during normal play, jumping on a trampoline, etc). These patients were slimmer with a significantly lower body mass index (BMI). All of the patients with lead breakage had a BMI of 20 or lower. The complications not related to trauma included accidental dislodgement of a temporary lead and removal of the device due to leg pain that was not corrected with lead re-positioning.
Although the authors suggest that new leads could be developed by the company to account for the needs of pediatric patients, they acknowledge that this is unlikely to happen, as there is little financial incentive to cater to this population. Instead, parents should be cautioned that slim, active children may be at higher risk for complications related to trauma.
Presented by Matthew Mason at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Vanderbilt University, Nashville, TN USA
Reported by Michaella M. Prasad, MD (Medical University of South Carolina, Charleston, SC USA), medical writer for UroToday.com