Sacral neuromodulation; apromising treatment for children with refractory functional constipation: LTP47

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Aim:Sacral neuromodulation (SNM) has been successfully applied in adult patients with urinary and fecal incontinence and more recently in adults with functional constipation.1-4 To describepreliminary results of SNM in children with chronic functional constipation refractory to intensive conservative treatment.Method:Children with functional constipation according to the ROME III criteria not responding to intensive conservative treatment (laxatives, enemas and colonic lavage) were assigned for SNM andprospectively followed up to at least 6 months after implantation by interviews and bowel diaries. Improvement was defined as spontaneous defecation > 3 times a week.Results:Five patients (all females), 14-18 years old had no spontaneous defecation or felt urge to defecate. Duration of symptoms varied from 6 to 18 years and the duration of treatment differed from 1-17 years. After implantation of the permanent neuromodulator, all children had a normal spontaneous defecation pattern of > 3 times a week without further medication and felt urge to defecate without anyproblems up till 6 months after implantation. Abdominal pain disappeared. Wexner score decreased from 20 to 8.Conclusion:SNM is apromising new treatment option in children with refractory functional constipation not responding to intensive conservative therapy.

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