Skip to main content

Advertisement

SpringerLink
Log in

Systematic review: sacral nerve stimulation in the treatment of constipation and fecal incontinence in children with emphasis in anorectal malformation

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Background

Sacral nerve stimulation (SNS) is frequently used for constipation and fecal incontinence in the adult literature. The purpose of this study is to perform a systemic review of the literature for SNS for constipation and fecal incontinence in children with emphasis in anorectal malformations.

Methods

Systematic literature review was conducted to include all SNS studies in patients < 19 years of age. Studies were separated into those for (1) constipation, (2) bowel and bladder dysfunction, and (3) anorectal malformations.

Results

28 articles were included in the review: (1) 12 constipation (269 patients) and (2) 16 bowel and bladder dysfunction (441 patients). Some studies overlapped groups, as they included some patients with anorectal malformations (4 articles and 29 patients). Constipation studies included slow transit and retention constipation and showed varying degrees of improvement. For bowel and bladder dysfunction, studies also reported varying degrees of improvement using different measures (number of bowel movements per day, transit times, and soiling improvement). There was no specific description of the results in anorectal malformation (ARM) cases and also information regarding specific ARM type, sacral ratio, or presence of tethered cord.

Conclusions

SNS for constipation and urinary problems seems to be promising. Data are limited and heterogeneous, and SNS cannot be definitively encouraged or discouraged in patients with ARM, based on current studies. Future studies should include more objective measurements of bowel outcomes and specify outcomes related to patients with anorectal malformations including information regarding their specific malformation, sacral ratio, and presence of tethered cord. Complications’ rate is considerable high.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Dwyer ME, Vandersteen DR, Hollatz P, Reinberg YE (2014) Sacral neuromodulation for the dysfunctional elimination syndrome: a 10-year single-center experience with 105 consecutive children. Urology 84:911–917

    Article  PubMed  Google Scholar 

  2. Haddad M, Besson R, Aubert D et al (2010) Sacral neuromodulation in children with urinary and fecal incontinence: a multicenter, open label, randomized, crossover study. J Urol 184:696–701

    Article  CAS  PubMed  Google Scholar 

  3. Lordelo P, Soares PV, Maciel I et al (2009) Prospective study of transcutaneous parasacral electrical stimulation for overactive bladder in children: long-term results. J Urol 182:2900–2904

    Article  PubMed  Google Scholar 

  4. Lu PL, Asti L, Lodwick DL et al (2017) Sacral nerve stimulation allows for decreased antegrade continence enema use in children with severe constipation. J Pediatr Surg 52:558–562

    Article  PubMed  Google Scholar 

  5. Lu PL, Koppen IJN, Orsagh-Yentis DK et al (2018) Sacral nerve stimulation for constipation and fecal incontinence in children: long-term outcomes, patient benefit, and parent satisfaction. Neurogastroenterol Motil 30:e13184

    Article  Google Scholar 

  6. Stephany HA, Juliano TM, Clayton DB et al (2013) Prospective evaluation of sacral nerve modulation in children with validated questionnaires. J Urol 190:1516–1522

    Article  PubMed  Google Scholar 

  7. Sulkowski JP, Nacion KM, Deans KJ et al (2015) Sacral nerve stimulation: a promising therapy for fecal and urinary incontinence and constipation in children. J Pediatr Surg 50:1644–1647

    Article  PubMed  Google Scholar 

  8. Ladi-Seyedian SS, Sharifi-Rad L, Manouchehri N, Ashjaei B (2017) A comparative study of transcutaneous interferential electrical stimulation plus behavioral therapy and behavioral therapy alone on constipation in postoperative Hirschsprung disease children. J Pediatr Surg 52:177–183

    Article  PubMed  Google Scholar 

  9. van Wunnik BP, Peeters B, Govaert B et al (2012) Sacral neuromodulation therapy: a promising treatment for adolescents with refractory functional constipation. Dis Colon Rectum 55:278–285

    Article  PubMed  Google Scholar 

  10. Yik YI, Ismail KA, Hutson JM, Southwell BR (2012) Home transcutaneous electrical stimulation to treat children with slow-transit constipation. J Pediatr Surg 47:1285–1290

    Article  PubMed  Google Scholar 

  11. Yik YI, Stathopoulos L, Hutson JM, Southwell BR (2016) Home transcutaneous electrical stimulation therapy to treat children with anorectal retention: a pilot study. Neuromodulation 19:515–521

    Article  PubMed  Google Scholar 

  12. Ismail KA, Chase J, Gibb S et al (2009) Daily transabdominal electrical stimulation at home increased defecation in children with slow-transit constipation: a pilot study. J Pediatr Surg 44:2388–2392

    Article  PubMed  Google Scholar 

  13. Singh HUJ, Khatun M, Connor F (2017) Lumbosacral transcutaneous electrical stimulation in children with slow transit constipation: a pilot case series. J Hepatol Gastroenterol 2:1–6

    Google Scholar 

  14. van der Wilt AA, van Wunnik BP, Sturkenboom R et al (2016) Sacral neuromodulation in children and adolescents with chronic constipation refractory to conservative treatment. Int J Colorectal Dis 31:1459–1466

    Article  PubMed  PubMed Central  Google Scholar 

  15. Case J, Robertson VJ, Southwell B et al (2005) Pilot study using transcutaneous electrical stimulation (interferential current) to treat chronic treatment-resistant constipation and soiling in children. J Gastroenterol Hepatol 20:1054–1061

    Article  Google Scholar 

  16. Clarke MC, Chase JW, Gibb S et al (2009) Decreased colonic transit time after transcutaneous interferential electrical stimulation in children with slow transit constipation. J Pediatr Surg 44:408–412

    Article  PubMed  Google Scholar 

  17. Leong LC, Yik YI, Catto-Smith AG et al (2011) Long-term effects of transabdominal electrical stimulation in treating children with slow-transit constipation. J Pediatr Surg 46:2309–2312

    Article  PubMed  Google Scholar 

  18. Fuchs ME, Lu PL, Vyrostek SJ et al (2017) Factors predicting complications after sacral neuromodulation in children. Urology 107:214–217

    Article  PubMed  Google Scholar 

  19. Kajbafzadeh AM, Sharifi-Rad L, Ladi-Seyedian SS, Mozafarpour S (2016) Transcutaneous interferential electrical stimulation for the management of non-neuropathic underactive bladder in children: a randomised clinical trial. BJU Int 117:793–800

    Article  PubMed  Google Scholar 

  20. Lecompte JF, Hery G, Guys JM, Louis-Borrione C (2015) Evaluation of transcutaneous electrical posterior tibial nerve stimulation for the treatment of fecal and urinary leaks in children: preliminary results. J Pediatr Surg 50:630–633

    Article  PubMed  Google Scholar 

  21. Mason MD, Stephany HA, Casella DP et al (2016) Prospective evaluation of sacral neuromodulation in children: outcomes and urodynamic predictors of success. J Urol 195:1239–1244

    Article  PubMed  Google Scholar 

  22. McGee SM, Routh JC, Granberg CF et al (2009) Sacral neuromodulation in children with dysfunctional elimination syndrome: description of incisionless first stage and second stage without fluoroscopy. Urology 73:641–644 (discussion 644)

    Article  PubMed  Google Scholar 

  23. Quintiliano F, Veiga ML, Moraes M et al (2015) Transcutaneous parasacral electrical stimulation vs oxybutynin for the treatment of overactive bladder in children: a randomized clinical trial. J Urol 193:1749–1753

    Article  CAS  PubMed  Google Scholar 

  24. Roth TJ, Vandersteen DR, Hollatz P et al (2008) Sacral neuromodulation for the dysfunctional elimination syndrome: a single center experience with 20 children. J Urol 180:306–311 (discussion 311)

    Article  PubMed  Google Scholar 

  25. Veiga ML, Queiroz AP, Carvalho MC et al (2016) Parasacral transcutaneous electrical stimulation for overactive bladder in children: an assessment per session. J Pediatr Urol 12:293 e291–293 e295

    Google Scholar 

  26. Humphreys MR, Vandersteen DR, Slezak JM et al (2006) Preliminary results of sacral neuromodulation in 23 children. J Urol 176:2227–2231

    Article  PubMed  Google Scholar 

  27. Drossman DA, Hasler WL (2016) Rome IV-functional GI disorders: disorders of gut-brain interaction. Gastroenterology 150:1257–1261

    Article  PubMed  Google Scholar 

  28. Agachan F, Chen T, Pfeifer J et al (1996) A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 39:681–685

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, International Center for Colorectal and Urogenital Care, Children’s Hospital Colorado, University of Colorado, Box 323, 13123 East 16th Avenue, Anschutz Medical Campus, Aurora, CO, 80045, USA

    Andrew Trecartin, Alberto Peña & Andrea Bischoff

  2. Department of Surgery, University of Colorado, Aurora, CO, USA

    Lindel Dewberry

  3. Medical Library, Children’s Hospital Colorado, Aurora, CO, USA

    Marie St. Pierre

Authors
  1. Lindel Dewberry
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew Trecartin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alberto Peña
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marie St. Pierre
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrea Bischoff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Bischoff.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was not obtained, as identifiable information was not included in the manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dewberry, L., Trecartin, A., Peña, A. et al. Systematic review: sacral nerve stimulation in the treatment of constipation and fecal incontinence in children with emphasis in anorectal malformation. Pediatr Surg Int 35, 1009–1012 (2019). https://doi.org/10.1007/s00383-019-04515-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-019-04515-z

Keywords

Search

Navigation