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Review
. 2023 Feb 2;13(2):430.
doi: 10.3390/life13020430.

Transcutaneous Neuromodulation for Constipation and Fecal Incontinence in Children: A Systematic Review and Meta-Analysis

Ronny Rodrigues Correia  1 , Luis Felipe Orsi Gameiro  2 , Nathalia Grion Trevisane  1 , Matheus Bertanha  1 , Erika Veruska Paiva Ortolan  1 , Pedro Luiz Toledo de Arruda Lourenção  1
Affiliations
Review

Transcutaneous Neuromodulation for Constipation and Fecal Incontinence in Children: A Systematic Review and Meta-Analysis

Ronny Rodrigues Correia et al. Life (Basel). .

Abstract

Introduction: Constipation is a disorder with a multifactorial origin. Constipation has a varied clinical presentation, including infrequent defecation of bulky stools and episodes of retentive fecal incontinence. Neuromodulation has been used to treat many health problems, with promising results.

Objective: To conduct a systematic review of randomized clinical trials based on the effects of transcutaneous neuromodulation in treating constipation and retentive fecal incontinence in children and adolescents.

Methods: A systematic review of randomized clinical trials was performed. Medline (PubMed), PEDro, SciELO, Cochrane (CENTRAL), Embase, and Scopus databases were searched from March 2000 to August 2022. We included clinical trials evaluating transcutaneous neuromodulation in children with constipation and fecal incontinence compared or associated with other types of treatment. Two reviewers independently selected relevant studies, assessed the methodological quality, and extracted the data.

Results: Three studies with 164 participants were included in this review. Two meta-analyses were generated based on these studies. These analyses revealed that transcutaneous neuromodulation is an effective adjuvant treatment modality that improves children's constipation and retentive fecal incontinence. The methodological quality of the included studies was classified as high based on the assessment of the quality of evidence, with a high degree of confidence based on the GRADE system.

Conclusions: Transcutaneous neuromodulation is an effective adjuvant treatment modality for children with constipation and retentive fecal incontinence.

Keywords: children; constipation; fecal incontinence; neuromodulation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Access and selection flow diagram of the inclusion and exclusion studies.
Figure 2
Figure 2
Meta-analysis comparing constipation improvement in patients who underwent transcutaneous neuromodulation associated with other therapies (Group 1) and those who underwent other therapies with or without sham (Group 2) [14,15,16].
Figure 3
Figure 3
Meta-analysis comparing fecal incontinence improvement in patients who underwent transcutaneous neuromodulation associated with other therapies (Group 1) and those who underwent other therapies with or without sham (Group 2) [14,15,16].
Figure 4
Figure 4
A funnel plot showing the meta-analysis of transcutaneous neuromodulation associated with other therapies versus other therapies with or without sham for the constipation outcome.
Figure 5
Figure 5
A funnel plot showing the meta-analysis of transcutaneous neuromodulation associated with other therapies versus other therapies with or without sham for the fecal incontinence outcome.
Figure 6
Figure 6
Risk of bias summary: analysis of the authors’ judgments on each risk of bias item for the included studies [14,15,16].
Figure 7
Figure 7
The quality of scientific evidence and the strength of recommendation for fecal incontinence and constipation outcomes.
See this image and copyright information in PMC

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