Original Article

Spinal Cord (2008) 46, 517–522; doi:10.1038/sj.sc.3102167; published online 4 March 2008

Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study

G Del Popolo1, G Mosiello2, C Pilati3, M Lamartina4, F Battaglino5, P Buffa6, T Redaelli7, G Lamberti8, M Menarini9, P Di Benedetto10 and M De Gennaro2

  1. 1Neuro-Urology Spinal Unit, University of Florence, Florence, Italy
  2. 2Neurourology and Urodynamics Unit, Bambino Gesù Children's Hospital, Rome, Italy
  3. 3Spinal Unit, CTO Hospital, Rome, Italy
  4. 4Urologic Unit, Villa delle Ginestre Hospital, Palermo, Italy
  5. 5Spina Bifida Unit, Hospital of Vicenza, Vicenza, Italy
  6. 6Pediatric Surgery Department, Giannina Gaslini Institute, Genova, Italy
  7. 7Spinal Unit, Niguarda Hospital, Milan, Italy
  8. 8Rehabilitation Institute, Caraglio, Italy
  9. 9Montecatone Rehabilitation Institute, Imola, Italy
  10. 10Gervasutta Rehabilitation Institute, Udine, Italy

Correspondence: Dr G Mosiello, Bambino Gesù Children's Hospital Urodynamic Unit, Piazza S Onofrio 4, Rome 00165, Italy. E-mail: mosiello@opbg.net

Received 20 May 2007; Revised 13 December 2007; Accepted 15 December 2007; Published online 4 March 2008.

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Abstract

Study design:

 

Thirty-six patients with unsatisfactory treatment of neurogenic bowel dysfunctions (NBD) were enrolled from Spinal Units and Rehabilitation Centers in Italy. Treatment was for 3 weeks using a newly developed integrated system with an enema continence catheter for transanal irrigation (Peristeen, Coloplast A/S Kokkedal Denmark).

Objectives:

 

To evaluate the effects of Peristeen Anal Irrigation on NBD and patient quality of life (QoL).

Setting:

 

Italy.

Methods:

 

Lesion level, ambulatory status and hand functionality were determined in all patients. NBD symptoms and QoL were evaluated before and after treatment, using a specific questionnaire. Statistical analysis was performed using McNemar Test and Sign Test.

Results:

 

Thirty-six patients were enrolled, and 32 patients completed the study. At the end of the treatment, 28.6% of patients reduced or eliminated their use of pharmaceuticals. Twenty-four patients became less dependent on their caregiver. There was a significant increase in patients' opinion of their intestinal functionality (P=0.001), QoL score (P=0.001) and their answers regarding their degree of satisfaction (P=0.001). A successful outcome was recorded for 68% of patients with fecal incontinence, and for 63% of patients with constipation.

Conclusion:

 

Peristeen Anal Irrigation is a simple therapeutic method for managing NBD and improving QoL. It should be considered as the treatment of choice for NBD, playing a role in the neurogenic bowel analogous to that of intermittent clean catheterization in bladder treatment.

Keywords:

neurological diseases, constipation, fecal incontinence, quality of life

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