Sacral Neuromodulation in Children and Adolescents

Inclusion Criteria:

• age between 2-17 years

• informed consent

• chronic constipation according to the ROME IV criteria for more than 3 months withor without encopresis/soiling despite underlying diseases such as slow-transitconstipation, rectal evacuation disorders or Hirschsprung's disease.

• refractory to conventional treatment in an appropriate weight-adapted application (training for bowel movements, lifestyle changes, pelvic floor training,pharmacological options)

• in cases of Hirschsprung's disease: diagnosis confirmed histologically by rectalbiopsies and in case of resection of an aganglionic segement: period between surgeryand SNM at least 1 year

• in cases of anorectal malformation or mechanical obstruction: post-surgical status:period between surgery and SNM at least 1 year

Exclusion Criteria:

• metabolic, inflammatory, and hormonal causes for chronic constipation

• toxic megacolon or further emergencies, which must be treated surgically

• sacral fractures or substantial differences in the sacral anatomy

• inflammatory bowel disorders

• rectal prolapse

• neuronal malignancies under medical and radiation therapy

• seizures