Sacral nerve stimulation for constipation and fecal incontinence in children: Long‐term outcomes, patient benefit, and parent satisfaction

• DOI: 10.1111/nmo.13184
• Publication Date: 2017-08-11T03:52:43Z
• Authors: P. L. Lu; I. J. N. Koppen; D. K. Orsagh‐Yentis; K. Leonhart; E. J. Ambeba; K. J. Deans; P. C. Minneci; S. Teich; K. A. Diefenbach; S. A. Alpert; M. A. Benninga; D. Yacob; C. Di Lorenzo
• Keywords: Fecal Incontinence; Sacral nerve stimulation; Functional constipation

Abstract Objective To evaluate the long‐term efficacy of sacral nerve stimulation ( SNS ) in children with constipation and describe patient benefit parent satisfaction. Methods Using a prospective registry, we identified patients <21 years old treated for >2 years. We compared symptoms, medical treatment, PedsQL Gastrointestinal Symptom Scale GSS ), Fecal Incontinence Quality Life FIQL Severity Index FISI before at follow‐up. contacted parents to administer Glasgow Children's Benefit Inventory GCBI satisfaction questionnaire. Key Results included 25 (52% male, median age 10 years): 16 had functional constipation, six anorectal malformation, two tethered spinal cord, one Hirschsprung's disease. Defecation frequency did not change after but reporting fecal incontinence decreased from 72% 20% P <.01) urinary 56% 28% =.04). Patients using laxatives 64% 44% (ns) antegrade enemas 48% =.03). GSS, most domains, were improved Six (24%) complications requiring further surgery. Of contacted, 15 (94%) indicated positive health‐related all would recommend other families. Conclusions & Inferences Sacral is promising durable treatment refractory appears particularly effective decreasing incontinence. Although quarter experienced additional surgery, nearly reported benefit. Future studies identify predictors response are needed.