Noninvasive Sacral Neuromodulation in Children and Adolescents: A Case-Control Study of Patients With Chronic Refractory Constipation

Diez S, Kirchgatter A, Adam D, Füldner A, Müller H, Matzel K, Besendörfer M (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Neuromodulation Wiley-Blackwell

DOI: 10.1016/j.neurom.2022.08.451

Abstract

Objectives: In adult patients with chronic refractory constipation, invasive sacral neuromodulation (SNM) has been applied successfully. There is a need for less invasive solutions while providing comparable therapeutic effects in children and adolescents. We present a prospective, interventional case-control study on the application of noninvasive SNM. Materials and Methods: Patients with chronic constipation refractory to conservative treatment were prospectively included in the study from 2018 to 2021 and randomized to either SNM (SNM group: single current stimulation for 24 h/d, frequency 15 Hz, pulse width 210 μs, intensity 1–10 mA) or conventional treatment (controls: full range of pharmacologic and nonpharmacologic options). Treatment was conducted for 12 weeks. Treatment effects were collected with specialized questionnaires and quality-of-life analysis (KINDLR). Outcome variables were defecation frequency, stool consistency, fecal incontinence (FI) episodes, and abdominal pain. Results: Analysis was conducted in 28 patients with SNM and 31 controls (median age 7.0, range 3–16 years). Overall responsiveness to treatment was 86% of the SNM group and 39% of the control group (p < 0.001). All outcome variables were positively influenced by SNM treatment. Defecation frequency improved in 46% of patients with SNM and in 19% of controls (p = 0.026), as did stool consistency in 57% of patients with SNM and in 26% of controls (p = 0.014). Fecal incontinence was significantly reduced in 76% of patients with SNM (n = 16/21 vs 42% of controls [n = 11/26], p = 0.042). Quality of life improved significantly during SNM treatment (71.32 [baseline] vs 85.00 [after 12 weeks], p < 0.001) and confirmed a positive influence of SNM treatment compared with the control group (85.00 [SNM after 12 weeks] vs 79.29 [controls after 12 weeks], p = 0.047). Conclusions: Outcome of noninvasive SNM treatment in patients with chronic refractory constipation is better than conventional treatment.

Authors with CRIS profile

Sonja Diez Department of Paediatrics and Adolescent Medicine Arne Füldner Department of Paediatric Surgery Klaus Matzel Lehrstuhl für Allgemein- und Viszeralchirurgie Manuel Besendörfer Department of Paediatric Surgery

Related research project(s)

Non-invasive Sacral Nerve Stimulation in Children and Adolescents With Chronic Constipation Jan. 1, 2018 - Dec. 31, 2021

Involved external institutions

Philipps-Universität Marburg DE Germany (DE)

How to cite

APA:

Diez, S., Kirchgatter, A., Adam, D., Füldner, A., Müller, H., Matzel, K., & Besendörfer, M. (2022). Noninvasive Sacral Neuromodulation in Children and Adolescents: A Case-Control Study of Patients With Chronic Refractory Constipation. Neuromodulation. https://doi.org/10.1016/j.neurom.2022.08.451

MLA:

Diez, Sonja, et al. "Noninvasive Sacral Neuromodulation in Children and Adolescents: A Case-Control Study of Patients With Chronic Refractory Constipation." Neuromodulation (2022).

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