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- Title
Retrograde continence enema in children with spina bifida: Not as effective as first thought.
- Authors
King, Sebastian K; Stathopoulos, Lefteris; Pinnuck, Loreto; Wells, Judy; Hutson, John; Heloury, Yves
- Abstract
<bold>Aim: </bold>The aim of the study is to investigate the effectiveness of Peristeen retrograde continence enema (RCE) in the management of faecal incontinence in children with spina bifida.<bold>Methods: </bold>We identified a homogenous group of spina bifida patients in whom RCE was initiated (Jan 2006-July 2013). Confidential assessments included (i) Fecal Incontinence Quality Of Life (FIQOL), (ii) St Marks Faecal Incontinence score, (iii) Cleveland Clinic Constipation score and (iv) Neurogenic Bowel Dysfunction score.<bold>Results: </bold>Of 20 patients, 11 (mean age 14.5 ± 5.3 years) were male. Of 20 patients, nine were still using RCE (mean follow-up 4.1 years). Three patients ceased RCE within 10 days, six after 4-12 months and two after 36-48 months. Reasons for cessation included balloon difficulties (n = 4), procedure deemed too difficult (n = 4) and pain (n = 3). There were no differences between the groups in length of training time for technique, instillate fluid/volume used and time taken to perform RCE. There were no differences between the groups for quality of life, faecal incontinence or constipation scores.<bold>Conclusions: </bold>We demonstrated a high rate of cessation with RCE in patients with spina bifida. This could not be explained by associated conditions, or by enema-related parameters. One possible explanation is the lack of ongoing outpatient support for the children and their families.
- Subjects
FECAL incontinence in children; ENEMA; SPINA bifida; QUALITY of life; CONSTIPATION in children; THERAPEUTICS; TREATMENT of fecal incontinence; FECAL incontinence; INTERVIEWING; HEALTH outcome assessment; QUALITATIVE research; DISEASE complications
- Publication
Journal of Paediatrics & Child Health, 2017, Vol 53, Issue 4, p386
- ISSN
1034-4810
- Publication type
journal article
- DOI
10.1111/jpc.13408