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Promising New Treatment for Incontinence

As a pediatric urologist, I am often asked to see and treat children with various forms of urinary incontinence. This means a child doesn’t have control over his or her bladder, resulting in a daytime accident two or more times per month. Most children naturally grow out of this by the time they are out of kindergarten, although as many as one in every 10 kids will still have occasional nighttime bed wetting accidents through the age of 7.

Urinary incontinence can have many different causes. When it doesn’t go away on its own by school age, it can become an embarrassing and upsetting experience for kids and their families. Many kids with urinary incontinence also have constipation or other bladder or bowel problems.

Some children have physical problems that can be fixed with surgery, while others have functional or behavioral issues that can be treated with medication or therapy. However, there is a very small group of children who don’t get better with any of the typical treatments. When this happens, it’s easy to feel frustrated and helpless.

Until recently, we’ve had little else to offer these patients. But last year, Nationwide Children’s began to offer a promising treatment called sacral nerve stimulator therapy, which has been used for many years in adult patients with similar problems.

Nerves in the lower spine help control urinary and bowel function. The sacral nerve stimulator is a small wire and battery that gives off continuous, mild electric impulses sent through the nerves that control the function of the bladder and bowel. It is surgically placed under the skin of the lower back.

For children who previously had to deal with the embarrassment and limitations of  urinary and fecal problems, successful sacral nerve stimulation therapy can mean a normal life of school, sports and fun—without accidents and medications.

But this treatment isn’t for everyone. Patients are screened and carefully selected for this procedure, since sacral nerve stimulation is considered a treatment of last resort for those who have failed all other conventional therapies.

We’ve used this therapy successfully to treat:
•    urinary urgency and frequency (overactive bladder)
•    urinary incontinence
•    urinary retention requiring self-catheterization
•    urinary tract infections due to bladder dysfunction
•    fecal retention and bowel dysfunction

In my clinic at Nationwide Children’s, we are actively studying the use of the sacral nerve stimulator to better understand its role in difficult cases of childhood urinary problems.  Our initial results are promising and have made a big difference in the lives of a small group of patients and their families. It’s very gratifying for me as a doctor to know that some kids who have previously had little hope for their complex urinary problems may now have hope to lead a more normal life.

For more information on Sacral Nerve Stimulator Therapy click here:

For more information on the Center for Colorectal and Pelvic Reconstruction click here:

 

Seth Alpert, MD
Seth Alpert, MD is an attending surgeon in the Section of Urology at Nationwide Children’s Hospital and Clinical Assistant Professor of Urology at The Ohio State University Medical Center. He is the urologic director of the sacral nerve stimulator program at NCH and in addition, his other clinical interests include hypospadias, hydronephrosis, vesicoureteral reflux, kidney stones, robotic and laparoscopic surgery, and urinary tract infections.

4 thoughts on “Promising New Treatment for Incontinence

  1. We are from Campbell River BC Canada.. My son was born with Spina Bifida and has a bladder 4 times too big that does not contract.. He is just turned 5 and he caths as well as has issues with his bowel. This sounds promising :)

  2. Cathy K on said:

    How do you know whether someone is a good candidate for this? My daughter has a neurogenic bladder and bowel due to sacral agenesis.

    1. Hi Cathy-Here is what Dr. Alpert had to say: “Good question. Unfortunately, sacral agenesis is not an indication for sacral nerve stimulator since the procedure relies on having normal nerve anatomy in this area and this is not the case with sacral agenesis. Others have tried this therapy for various forms of neurogenic bladder with mixed results and it is not yet clear which, if any, of these patients that it might help.” Hope that helps!

  3. Thank you, I’ve just been searching for info about this subject for
    a while and yours is the best I’ve discovered
    till now. However, what concerning the conclusion? Are you sure concerning the supply?

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