{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:11:18Z","timestamp":1790892678299,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T00:00:00Z","timestamp":1714780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Even if understanding of neuronal enteropathies, such as Hirschsprung's disease and functional constipation, has been improved, specialized therapies are still missing. Sacral neuromodulation (SNM) has been established in the treatment of defecation disorders in adults. The aim of the study was to investigate effects of SNM in children and adolescents with refractory symptoms of chronic constipation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A two\u2010centered, prospective trial has been conducted between 2019 and 2022. SNM was applied continuously at individually set stimulation intensity. Evaluation of clinical outcomes was conducted at 3, 6, and 12\u2009months after surgery based on the developed questionnaires and quality of life analysis (KINDL<jats:sub>R<\/jats:sub>). Primary outcome was assessed based on predefined variables of fecal incontinence and defecation frequency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Fifteen patients enrolled in the study and underwent SNM (median age 8.0\u2009years (range 4\u201317\u2009years)): eight patients were diagnosed with Hirschsprung's disease (53%). Improvement of defecation frequency was seen in 8\/15 participants (53%) and an improvement of fecal incontinence in 9\/12 patients (75%). We observed stable outcome after 1\u2009year of treatment. Surgical revision was necessary in one patient after electrode breakage. Urinary incontinence was observed as singular side effect of treatment in two patients (13%), which was manageable with the reduction of stimulation intensity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SNM shows promising clinical results in children and adolescents presenting with chronic constipation refractory to conservative therapy. Indications for patients with enteral neuropathies deserve further confirmation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14808","type":"journal-article","created":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T10:44:02Z","timestamp":1714819442000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sacral neuromodulation in children and adolescents with defecation disorders"],"prefix":"10.1111","volume":"36","author":[{"given":"Manuel","family":"Besend\u00f6rfer","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of Pediatric Surgery, Friedrich\u2010Alexander\u2010Universit\u00e4t (FAU) Erlangen\u2010N\u00fcrnberg University Hospital Erlangen  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Knorr","sequence":"additional","affiliation":[{"name":"Pediatric Surgery RoMed Klinikum Rosenheim (former Pediatric Surgery and Orthopedics Hospital Barmherzige Br\u00fcder)  Rosenheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie","family":"Kirchgatter","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Pediatric Surgery, Friedrich\u2010Alexander\u2010Universit\u00e4t (FAU) Erlangen\u2010N\u00fcrnberg University Hospital Erlangen  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Hospital Marburg University of Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Reis Wolfertstetter","sequence":"additional","affiliation":[{"name":"Pediatric Surgery and Orthopedics Hospital Barmherzige Br\u00fcder  Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus E.","family":"Matzel","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Coloproctology, Friedrich\u2010Alexander\u2010Universit\u00e4t (FAU) Erlangen\u2010N\u00fcrnberg University Hospital Erlangen  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8864-3240","authenticated-orcid":false,"given":"Sonja","family":"Diez","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Pediatric Surgery, Friedrich\u2010Alexander\u2010Universit\u00e4t (FAU) Erlangen\u2010N\u00fcrnberg University Hospital Erlangen  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2012.234"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmgh.2018.04.003"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000486"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2005.00751.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12386"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12905"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39231.633275.AD"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurom.2022.08.451"},{"key":"e_1_2_11_10_1","unstructured":"Ravens\u2010SiebererUBM.KINDL\u2010R English questionnaire for measuring health\u2010related quality of life in children and adolescents. 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