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 with or without encopresis/soiling despite underlying diseases such as slow-transit constipation, 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 rectal biopsies and in case of resection of an aganglionic segement: period between surgery and 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