Abstract：
OBJECTIVE: The aim of this article is to review considerations and efficacy of third-line treatments for pediatric non-neurogenic bladder dysfunction, including Botulinum toxin A (BoTNA), Posterior Tibial Nerve Stimulation (PTNS), and Sacral Neuromodulation (SNM).
RESULTS: Federal Drug Administration approval for use of beta-3-agonists in overactive detrusor activity in pediatric patients may provide an additional step prior to third-line therapies. New long-term data on pediatric SNM efficacy, complications, and revision rates will provide valuable information for counseling families. BoTNA offers a safe and efficacious treatment to decrease detrusor contractility and improve bladder capacity but is limited by the half-life of BoNTA agent. Percutaneous or transcutaneous PTNS offers improved voided volumes or cure in some patients but is time-intensive. SNM can be utilized in a variety of LUTD pathology with high success rate and cure but should consider cumulative anesthetic and fluoroscopic exposures for battery replacements and re-positioning for patient growth.
RESULTS: Federal Drug Administration approval for use of beta-3-agonists in overactive detrusor activity in pediatric patients may provide an additional step prior to third-line therapies. New long-term data on pediatric SNM efficacy, complications, and revision rates will provide valuable information for counseling families. BoTNA offers a safe and efficacious treatment to decrease detrusor contractility and improve bladder capacity but is limited by the half-life of BoNTA agent. Percutaneous or transcutaneous PTNS offers improved voided volumes or cure in some patients but is time-intensive. SNM can be utilized in a variety of LUTD pathology with high success rate and cure but should consider cumulative anesthetic and fluoroscopic exposures for battery replacements and re-positioning for patient growth.
摘要：
目的：本文的目的是回顾三线治疗小儿非神经源性膀胱功能障碍的注意事项和疗效，包括肉毒杆菌毒素A（BoTNA），胫骨后神经刺激(PTNS),和骶神经调节（SNM）。
结果：联邦药物管理局批准β-3-激动剂用于儿科患者逼尿肌过度活动的治疗可能会在三线治疗之前提供一个额外的步骤。儿科SNM疗效的新长期数据，并发症,和修订率将为咨询家庭提供有价值的信息。BoTNA提供了一种安全有效的治疗方法，可以降低逼尿肌收缩力并改善膀胱容量，但受BoNTA药物半衰期的限制。经皮或经皮PTNS在某些患者中提供了改善的排尿量或治愈，但时间密集。SNM可用于各种LUTD病理中，具有很高的成功率和治愈性，但应考虑累积麻醉和透视暴露，以更换电池和重新定位以促进患者生长。
结果：联邦药物管理局批准β-3-激动剂用于儿科患者逼尿肌过度活动的治疗可能会在三线治疗之前提供一个额外的步骤。儿科SNM疗效的新长期数据，并发症,和修订率将为咨询家庭提供有价值的信息。BoTNA提供了一种安全有效的治疗方法，可以降低逼尿肌收缩力并改善膀胱容量，但受BoNTA药物半衰期的限制。经皮或经皮PTNS在某些患者中提供了改善的排尿量或治愈，但时间密集。SNM可用于各种LUTD病理中，具有很高的成功率和治愈性，但应考虑累积麻醉和透视暴露，以更换电池和重新定位以促进患者生长。
