Factors Predicting Complications after Sacral Neuromodulation in Children

Abstract Objectives To identify if any pre-operative variable are associated with post-operative complications after pediatric sacral neuromodulation (SNM). Methods A review of all patients undergoing SNM with an implantable pulse generator at our institution was performed. Post-operative infection, lead migration, lead breakage and need for reoperation were recorded in a prospective database. We collected demographic information and indication for the procedure. We defined indication for procedure as either primarily bowel, or primarily bladder symptoms. Multivariate analysis was used to determine any associations between pre-operative factors and post-operative complications. Results Sixty-three children (34 females, 29 males) underwent SNM from 2012 – 2015. Mean age was 11.5 yrs and BMI was 51st percentile for age. SNM was placed for primarily bowel symptoms in 49% and for primarily bladder symptoms in 51%. Follow up was 1.9 years (0.19 – 4.3). Reoperation was required in 25% with mean time to reoperation of 10.9 months (0.9 – 31.5). Lead migration occurred in 17.4% and wound infection in 8%. There were no significant associations between patient age, gender or BMI and need for reoperation, wound infection or lead migration. Low BMI had no increased risk for lead complications (p=0.115). There was a significant increase in lead migration in the children who underwent SNM for primarily bladder symptoms (p=0.0034). Conclusions There is no association between age, gender or BMI with post-operative complications in this large cohort of pediatric SNM. Children with primarily bladder symptoms may have higher rate of lead complications for unclear reasons.