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

 

 

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.

 

 

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:

 

36             patients were enrolled, and

32             patients completed the study.

28.6%       of patients reduced or eliminated their use of                                 pharmaceuticals At the end of the treatment,.

24             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.

 

 

1              Neuro-Urology Spinal Unit, University of Florence, Florence, Italy

2              Neurourology and Urodynamics Unit, Bambino Gesù Children's Hospital, Rome, Italy

3              Spinal Unit, CTO Hospital, Rome, Italy

4              Urologic Unit, Villa delle Ginestre Hospital, Palermo, Italy

5              Spina Bifida Unit, Hospital of Vicenza, Vicenza, Italy

6              Pediatric Surgery Department, Giannina Gaslini Institute, Genova, Italy

7              Spinal Unit, Niguarda Hospital, Milan, Italy

8              Rehabilitation Institute, Caraglio, Italy

9              Montecatone Rehabilitation Institute, Imola, Italy

10         Gervasutta Rehabilitation Institute, Udine, Italy

 

Published online 4 March 2008.

Nature Journal