Sacral nerve stimulation allows for decreased antegrade continence enema use in children with severe constipation
Topic overview
Prospective registry study of 22 pediatric patients demonstrates that sacral nerve stimulation significantly reduces antegrade continence enema dependence in children with severe constipation, with 45% achieving cecostomy/appendicostomy closure within 2 years. Median ACE frequency decreased from 7 to 1 per week at 12 months, though 27% experienced complications requiring additional surgery.
Key takeaways
- SNS reduced ACE frequency from 7/week to 1/week at 12 months in children with severe constipation (p<0.0001)
- 45% of patients had their cecostomy/appendicostomy closed after SNS, demonstrating potential for procedural reversal
- Quality of life measures (GSS, FIQL, DES) remained unchanged despite decreased ACE dependence
- 27% complication rate requiring additional surgery highlights need for careful patient selection and counseling
- SNS offers alternative management for ACE-dependent constipation but doesn't eliminate need for laxatives
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