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Sacral nerve stimulation is a promising new therapeutic modality for pediatric urinary or fecal incontinence and chronic constipation in children when all other treatments have been unsuccessful. While a few other children’s hospitals in the United States offer sacral nerve stimulation based on subjective criteria and clinical symptoms, Nationwide Children’s is one of the first to structure this therapy by evaluating objective bladder and bowel function studies before and after the procedure to assess treatment response.
Sacral nerve stimulation (sometimes called sacral neuromodulation) is used as a last resort, after the patient has failed all other treatments such as medications and behavioral therapy. It involves surgical implantation of the device to address communication problems between the brain and the nerves that control bowel and bladder function. If the nerves are not communicating properly, the muscles may not function properly which leads to control problems (incontinence).
The implanted device delivers mild electrical impulses to the pelvic nerves. The pelvic nerves, in turn, begin to tell the muscles when to contract, ultimately helping control the ability to urinate or have a bowel movement.
At Nationwide Children’s, pediatric specialists in Gastroenterology, Urology and Surgery work closely with the child’s family, primary care physician and other pediatric specialists to determine if the patient may benefit from sacral nerve stimulation.
The first stage of therapy is a test phase, involving the temporary placement of an electrical stimulator. If the patient shows significant improvement in bowel or bladder control during the test phase, the surgeon implants a permanent electrical stimulator. Members of the care team continue to monitor the patient’s progress as he or she reintegrates into daily activities.
Sacral nerve stimulation will only be considered for patients meeting specific criteria, and only after traditional treatment methods have been explored. We also consider the unique difficulties of each patient, whether bladder incontinence, bowel incontinence, constipation, or varying combinations. Before an appointment can be scheduled, we need to speak directly with a patient’s primary care physician or pediatric specialist (gastroenterologist, urologist, etc.).
Physicians: To discuss the needs of your patient and whether sacral nerve stimulation may be an appropriate therapy, please call (614) 722-0448.