Retrograde continence enema in children with spina bifida: Not as effective as first thought
AuthorKing, SK; Stathopoulos, L; Pinnuck, L; Wells, J; Hutson, J; Heloury, Y
Source TitleJournal of Paediatrics and Child Health
Rural Clinical School
Document TypeJournal Article
CitationsKing, S. K., Stathopoulos, L., Pinnuck, L., Wells, J., Hutson, J. & Heloury, Y. (2017). Retrograde continence enema in children with spina bifida: Not as effective as first thought. JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 53 (4), pp.386-390. https://doi.org/10.1111/jpc.13408.
Access StatusOpen Access
AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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