%0 Journal Article
%T Third-Line Therapeutic Interventions for Non-Neurogenic Bladder Dysfunction in Children.
%A Lombardo AM
%A Alpert SA
%J Curr Urol Rep
%V 25
%N 12
%D 2024 Dec 2
%M 39093503
%F 2.862
%R 10.1007/s11934-024-01227-3
%X <B>OBJECTIVE: </B>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).<BR><B>RESULTS: </B>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.