Neurogenic colorectal dysfunction - use of new antegrade and retrograde colonic wash-out methods.

OBJECTIVES

To evaluate results of the Enema Continence Catheter (ECC) and the Malone Antegrade Continence Enema (MACE) applied in patients with severe neurogenic colorectal dysfunction.

METHODS

The ECC was offered to 21 patients (mean age 39.9, range 7 - 72 years). The MACE was used in eight patients (mean age 32.8 years, range 15 - 66 years). All patients still using the ECC or the MACE at follow-up were interviewed. Results from patients not available for follow-up were drawn from hospital records.

RESULTS

Overall success with the ECC was found in 12 of 21 patients (57%). In patients with faecal incontinence, the ECC was successful in eight out of eleven patients (73%), while four out of ten patients (40%) with constipation were successfully treated. Overall success with the MACE was found in seven out of eight patients (87%). Successful treatment with the ECC or the MACE was followed by significant improvement in quality of life.

CONCLUSION

The ECC is a simple therapeutic method in severe neurogenic colorectal dysfunction. If the ECC fails the MACE, as a minor and reversible operation, is a suitable alternative to more extensive procedures.