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

Spinal Cord. 2008 Jul;46(7):517-22. doi: 10.1038/sj.sc.3102167. Epub 2008 Mar 4.

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.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anal Canal*
  • Evaluation Studies as Topic
  • Female
  • Follow-Up Studies
  • Humans
  • Intestines / physiopathology
  • Italy
  • Male
  • Middle Aged
  • Quality of Life
  • Sickness Impact Profile
  • Spinal Cord Injuries / complications
  • Therapeutic Irrigation / methods
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / therapy*