For patients who struggle with bowel and bladder accidents, there are many treatment options that can help. Treatment options include medications, physical therapy, behavioral training, mechanical bowel flushes, and sometimes surgery.
Still, some patients struggle with accidents even after all the usual treatment options have been tried. For those patients, sacral nerve stimulation (SNS) might be an option. SNS (sometimes called sacral neuromodulation) involves a two-stage procedure. In the first stage, a special wire called a lead is surgically implanted into the area next to one of the child’s sacral nerves responsible for feeling and controlling urine and stool. The lead is then attached to a temporary stimulator outside of the body that will remain in place for 2-3 weeks to give the child and family members time to monitor the response to the device.
If the child has noticeable improvement in their urinary and bowel accidents during the trial period, the surgical team will then take the child back to the operating room and place a permanent electronic device under the skin that can be controlled by an external remote control. The family will learn how to check the function of the SNS and even adjust the settings if instructed to do so. After the initial recovery period, the patient will come for routine follow-up in person at least annually.
The leads and implanted SNS device work by improving the communication between the brain and the pelvic nerves by delivering mild electrical impulses to the pelvic nerves. The electrical impulses help the nerves in the pelvis tell the brain that it’s time to use the bathroom, and the brain is then able to tell the pelvic muscles to contract until the child can get to the restroom.
Not every patient will be a good candidate for a sacral nerve stimulator. Every patient’s medical history, surgical history, and developmental and behavioral history is considered when determining if they may benefit from SNS. SNS is usually only offered after patients have tried and failed the standard treatment options available. Patients interested in discussing SNS as an option should reach out to their provider team for an in-depth discussion.
Sarah Driesbach serves as an advance practitioner nurse at The Center for The Colorectal and Pelvic Reconstruction (CCPR) at Nationwide Children’s Hospital. Sarah utilizes her diverse background and experiences caring for patients with complex colorectal and urological conditions. Sarah joined the CCPR Team in 2017.
Alessandra Gasior, DO
Center for Colorectal and Pelvic Reconstruction (CCPR)
Dr. Gasior is the medical director of Colorectal Transitional Care at Nationwide Children’s Hospital and she is a surgeon with The Ohio State University Wexner Medical Center’s Division of Colon and Rectal Surgery to help ensure that patients with colorectal conditions have a smooth transition of care once they reach adulthood.
Karen A. Diefenbach, MD
Karen A. Diefenbach, MD, is the director for Minimally Invasive Surgery at Nationwide Children's Hospital, and associate professor in the Division of Pediatric Surgery at The Ohio State University College of Medicine. Dr. Diefenbach comes to Nationwide Children's from Yale University School of Medicine and Yale New Haven Children's Hospital where she was an attending surgeon, and an assistant professor in the Department of Surgery.
Browse by Author
About this Blog
Pediatric News You Can Use From America’s Largest Pediatric Hospital and Research Center
700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.