Long-term outcome of intractable constipation treated by sacral neuromodulation: a comparison between children and adults

Sander van Kuijk, M.A. Benninga, L.P.S. Stassen, Nicole Bouvy, Jarno Melenhorst, Stéphanie Breukink*, P.T. Janssen, Y.M. Meyer

*Corresponding author for this work

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Abstract

AimSacral neuromodulation (SNM) is a minimally invasive therapy for functional constipation (FC) and is most often used to treat adults. Recent studies suggest that SNM may also beneficial in children. However, comparative data regarding preferred age of SNM for FC are lacking. Therefore, long-term results of SNM for FC were compared between children and adults.

MethodAll patients treated with SNM for FC between 2004 and 2015 were evaluated. Outcomes of children (age 10-18years) were compared with those for adults (18years). The primary end-point was a defaecation frequency of three or more times per week, which is consistent with the ROME-III criteria. Secondary outcomes were quality of life (QoL; SF-36) and the Cleveland Clinic Constipation Score.

ResultsOne hundred and eighty patients (45 children, 135 adults) were eligible for SNM. The mean age was 15.8 (children) and 41.4years (adults). One hundred and twenty-six patients received permanent SNM (38 children, 88 adults). Mean follow-up was 47months in both groups. Defaecation frequency increased in both groups after SNM compared with baseline. Defaecation frequency in adults was higher than in children. The increased defaecation frequency was maintained during the entire follow-up period in both groups. QoL of children was impaired compared with the Dutch population with regard to bodily pain, general health and vitality. Adults had worse QoL with regard to physical functioning, bodily pain, general health, vitality and social functioning compared with the Dutch population. QoL of children did not differ from adults.

ConclusionSacral neuromodulation (SNM) should be considered in children (

Original languageEnglish
Pages (from-to)134-143
Number of pages10
JournalColorectal Disease
Volume20
Issue number2
DOIs
Publication statusPublished - Feb 2018

Keywords

  • Sacral neuromodulation
  • constipation
  • children
  • adults
  • quality of life
  • SLOW-TRANSIT CONSTIPATION
  • SF-36 HEALTH SURVEY
  • QUALITY-OF-LIFE
  • NERVE-STIMULATION
  • FECAL INCONTINENCE
  • IDIOPATHIC CONSTIPATION
  • MANAGEMENT
  • ADOLESCENTS
  • MODULATION
  • DISORDERS

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