Sacral Nerve Stimulation in Children with Medically Refractory Fecal Incontinence or Severe Constipation.
J Pediatr Surg
; 58(8): 1594-1599, 2023 Aug.
Article
em En
| MEDLINE
| ID: mdl-37221127
ABSTRACT
INTRODUCTION:
The goal of this study was to evaluate outcomes in patients treated with sacral nerve stimulation (SNS) for medically refractory fecal incontinence or severe constipation.METHODS:
We performed a retrospective cohort study of all patients treated with SNS after failed medical management at a single center between 9/1/2015 and 6/30/2022. Demographic and clinical data was extracted from the electronic medical record. Rates of involuntary bowel movements were evaluated using a bowel severity score questionnaire and compared pre- and post-SNS using McNemar and McNemar-Bowker tests.RESULTS:
70 patients underwent SNS placement. The median age was 12.8 years (IQR 8.6-16.0) and 61.4% were male. The most common diagnosis was idiopathic constipation (67.1%), followed by anorectal malformation (15.7%), and others. 43 patients had severity scores recorded both pre- and at least 90 days post-SNS insertion. The rates of daytime and nighttime involuntary bowel movements were significantly different pre-compared to post-SNS placement (p = 0.038 and p = 0.049, respectively). The rate of daytime and nighttime fecal continence increased from 44% to 58.1% and 53.5%-83.7%, respectively. The rate of at least weekly daytime and nighttime fecal incontinence decreased from 48.8% to 18.7% and 34.9%-7.0%, respectively. Minor pain/neurological symptoms occurred in 40% of patients, while 5.7% developed a wound infection. Further surgery for the SNS was required in 40% of patients.CONCLUSIONS:
SNS placement can be an effective treatment for medically refractory fecal incontinence. Minor complications and the need for further procedures are common, while more serious complications like wound infections are rare. TYPE OF STUDY Retrospective Cohort Study. LEVEL OF EVIDENCE Level 3.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Terapia por Estimulação Elétrica
/
Incontinência Fecal
Tipo de estudo:
Etiology_studies
/
Observational_studies
Idioma:
En
Revista:
J Pediatr Surg
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos