Most children with constipation or incontinence respond well to therapies such as dietary changes, medication, behavior modification and, in some cases, surgical intervention.
But for some children, these therapies are not successful. When this is the case, the care team at Colorectal Center may recommend sacral nerve stimulation. This treatment is clinically proven to stop or greatly reduce accidents related to constipation, fecal incontinence and urinary incontinence, and significantly improve a child’s quality of life. Cincinnati Children’s is one of only a few pediatric institutions in the country to offer this therapy.
A sacral nerve stimulator is a small transmitter that is placed under the skin in the upper buttock area. It delivers gentle electrical impulses through a probe (a thin wire) that is placed near the sacral nerve. The technology is similar to a pacemaker, but instead of regulating a person’s heartbeat, it stimulates the bowel, sphincter and bladder muscles to work normally.
Sacral nerve stimulation is considered a last resort when other therapies have failed. It can be very effective for children whose condition is likely caused by “communication problems” between the brain and nerves. This can be the case for children with Hirschsprung disease, spina bifida, idiopathic constipation and anorectal malformation, as well as for other patients. Your doctor can discuss with you whether this therapy is a good option for your child.
A Two-Phase Procedure
Sacral nerve stimulation involves two separate outpatient procedures. In the first procedure, the surgeon places the device under the skin for a “test” phase. For the next two to four weeks, you and your child will carefully record your child’s bowel and/or urinary activity, and compare it to past records. If the stimulator is having a positive effect, the surgeon will do a second procedure to implant the device for the long term. If not, the device will be removed.
The transmitter does not make any noise, and is not visible to others. You and your child will not need to “operate” it, although you can adjust the strength of the electrical pulse using a remote control device, if needed. Our team will provide your family with the education and support you need to make the most of this therapy.
Sacral nerve stimulation can be discontinued at any time without permanent damage to the nerves. When the battery power becomes low (usually within four to seven years), the surgeon will remove the transmitter and replace it with a new one.