The role of the Malone antegrade continence enema (MACE) in the management of myelodeysplatic patients.

Myelodysplasia is a congenital neural tube defect commonly affecting bladder and bowel function. Management of fecal incontinence is paramount to achieve patient independence and self-confidence. When conservative measures fail alternative invasive methods can be successfully applied. The Malone antegrade continence enema (MACE) was introduced in the late 1980's to treat spina bifida patients with fecal incontinence refractory to conservative management. Since its introduction, multiple successful variations have been described and its role has expanded. Indeed, the MACE has revolutionized the care of myelodysplastic patients, their bowel function, and ultimately their self image.