Sacral neuromodulation in children and adolescents with chronic constipation refractory to conservative treatment

• DOI: 10.1007/s00384-016-2604-8
• Publication Date: 2016-06-13T05:41:34Z
• Authors: Aart A. van der Wilt; Bart P. W. van Wu...; Rosel Sturkenboom; Ingrid J. Han-Geurts; Jarno Melenhorst; Marc A. Benninga; Cor G. M. I. Baeten; Stephanie O. Breu...
• Keywords: Obstructed defecation; Laxative; Refractory (planetary science)

Functional constipation in children and adolescents is a common invalidating condition. In minority of patients, symptoms persist despite optimal conservative therapy. The aim this study was to evaluate whether the short-term effects sacral neuromodulation (SNM) with are sustained over prolonged period time.Patients aged 10-20 years, refractory constipation, fulfilling Rome III criteria, were included our study. If SNM test treatment showed >50 % improvement defecation frequency, permanent stimulator implanted. Primary outcome measure frequency during 3 weeks. Secondary endpoints abdominal pain Wexner score. To assess sustainability effect, survival analysis performed. Cross-sectional quality life assessed using EQ-5D VAS score.Thirty girls, mean age 16 (range 10-20), included. increased from 5.9 (SD 6.5) 21 days at baseline 17.4 11.6) after weeks (p < 0.001). During treatment, score decreased 3.6 1.5 18.6 8.5 0.001), respectively. Improvement median follow-up 22.1 months (12.2-36.8) 42.9 patients. On scale 0 100, 7 points lower than norm (mean 70 vs. 77).SNM therapeutic option for chronic not responding intensive oral and/or laxative therapy, providing benefits that appear be time.