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306 Chapter 15 Patient benefit and parent satisfaction We called families a median of 2.3 years (IQR 2.1-2.7) after SNS initiation. We were able to contact the parents of 17 patients, including all six of the children who experienced complications after SNS initiation requiring further surgery. Sixteen parents (64%) agreed to participate and completed the GCBI and satisfaction questionnaire. The patient who declined to participate was one of the children who had experienced a local infection after SNS initiation. Median GCBI was +42.7 and 15 parents (94%) reported GCBI scores >0, indicating positive health-related benefit. The patient who had a negative GCBI score had undergone SNS replacement secondary to wound infection. Fourteen parents (88%) would proceed with SNS if given the opportunity to remake their decision. Two parents (13%) would not proceed with SNS, one because of complications requiring further surgery and the other because of lack of improvement. All 16 parents would recommend SNS to others. A summary of parent responses when asked to explain their answers to our satisfaction questionnaire is presented in Table 2. A full description of parent responses is provided in Supplemental file 1. TABLE 2: Summary of parent responses when asked to explain their answers to our satisfaction questionnaire (n=16). Positive responses ( n ) 1. SNS decreased the need for antegrade continence enemas (4) 2. SNS decreased the need for oral laxative treatment or bowel clean outs (3) 3. SNS improved constipation symptoms (3) 4. Parents have already recommended SNS to others (3) 5. SNS was life-changing (2) 6. SNS improved quality of life (2) Negative responses ( n ) 7. SNS improved urinary symptoms but not constipation symptoms (3) 8. Process of starting SNS and adjusting settings took too long (3) 9. SNS did not help symptoms (1) 10. SNS led to complications (1) Three parents reported that SNS improved urinary symptoms but not constipation symptoms, raising the possibility that parents of children with urinary symptoms reported greater patient benefit or parent satisfaction because of improvement in urinary symptoms alone. When we divided the 16 responding parents into parents of children with and without urinary symptoms, we found that the 12 parents of children with urinary symptoms