Malone antegrade continence enema for adults with neurogenic bowel disease

Joel M.H. Teichman, J. Mansel Harris, Donald M. Currie, Douglas B. Barber

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Purpose: We describe the outcomes of adults with neurogenic bowel disease who underwent a Malone antegrade continence enema procedure with or without concomitant urinary diversion. Materials and Methods: Consecutive adult patients with neurogenic bowel disease who underWent an antegrade continence enema procedure (continent catheterizable appendicocecostomy for fecal impaction) were retrospectively reviewed. Results: Of the 7 patients who underwent an antegrade continence enema synchronous urinary procedure (ileal conduit, augmentation ileocystoplasty with continent catheterizable abdominal stoma or augmentation ileocystoplasty) was also performed in 6. Mean patient age was 32 years and mean followup was 11 months. Of the 7 patients 6 who self-administered antegrade continence enemas regularly were continent of stool per rectum and appendicocecostemy, using the appendicocecostomy as the portal for antegrade enemas. All 6 compliant patients reported decreased toileting time and improved quality of life. Preoperative autonomic dysreflexia resolved postoperatively in 3 patients. All urinary tracts were stable. In 4 patients 5 complications occurred, including antegrade continence enema stomal stenosis requiring appendicocutaneous revision (1), antegrade continence enema stomal stenosis requiring dilation (1), superficial wound infection (1), small bowel obstruction requiring lysis of adhesions (1) and urinary incontinence (1 who underwent continent urinary diversion). Conclusions: Patients with neurogenic bladder and bowel disease may benefit from antegrade continence enema performed synchronously with a urinary procedure. Antegrade continence enema may be indicated alone for neurogenic bowel. Patient selection is important.

Original languageEnglish (US)
Pages (from-to)1278-1281
Number of pages4
JournalJournal of Urology
Volume160
Issue number4
DOIs
StatePublished - Oct 1998

Keywords

  • Bladder
  • Enema
  • Fecal incontinence
  • Neurogenic
  • Urinary incontinence

ASJC Scopus subject areas

  • Urology

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