From
Dr. Nelson G. Rosen
Sacral nerve stimulation for refractory pediatric fecal incontinence
With Dr. Ben Hamm · hosted by Dr. Jill Knepprath
Chapter 1 of 5
Introduction
Introduction and Clinical Question
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
In a sacral nerve stimulator trial, the rate of wearing a diaper during the day decreased from 19% to 2%.
Sacral nerve stimulation is not FDA approved in kids.
Side effects of sacral nerve stimulation include pain and neurological symptoms.
About 40% of patients require re-operation within about 3 years for dead battery of the stimulator.
The stimulator is placed through the 3rd sacral foramen and sends signals to the sacral nerves.
After placement, the patient is observed for a couple of weeks to assess symptom improvement.
Antegrade colonic enema procedures or cecostomy tubes are a reasonable next step for pediatric fecal incontinence refractory to medical management.
Overnight, the rate of the child needing a diaper went from 33% to 11% with sacral nerve stimulation.
A Cochrane review in adults suggests that sacral nerve stimulation can help with fecal incontinence and avoid an ACE procedure.
A 2023 study showed an improvement in involuntary daytime and nighttime bowel movements with sacral nerve stimulation.
If symptoms improve during the trial period, the stimulator can be implanted long-term.