Successful use of transcutaneous parasacral stimulation in a patient with myelomeningocele and fecal incontinence: A case report.

Abstract

Myelomeningocele is a complex congenital defect that affects the spinal cord and structures associated with it. These patients often have neurogenic bowel and bladder dysfunction with constipation, fecal and urinary incontinence. In addition to dietary modifications, laxatives, and enemas, therapies such as biofeedback and neurostimulation (invasive and noninvasive) are sometimes used. These techniques are rarely available, may require surgical procedures, and are not devoid of complications. We present the case of a 13-year-old boy with myelomeningocele at the L4 level, with constipation, dyssynergic defecation, and fecal incontinence (FI). He was treated with biofeedback achieving partial improvement of FI, and then with transcutaneous electrical neurostimulation (TENS) with subsequent resolution of constipation and FI. To our knowledge, this is the first case report using neurostimulation with TENS applied to the S2-S4 dermatomes in a patient with myelomeningocele. This represents a safe, noninvasive, and low-cost treatment for these patients.