OBJECTIVE: The objective was to study the effectiveness of a modified washing toilet seat equipped with a CCD camera monitor and an electronic bidet to facilitate precise hitting of the anal area with water streams to stimulate bowel movement in patients with spinal cord injury (SCI). DESIGN: There were 20 subjects, all of whom had traumatic SCI, were at least 5 mos post acute injury, and could change their position on the toilet seat while watching the monitor. Stimulation of bowel movement with the modified toilet seat was provided for a maximum of 30 mins. Success or failure to induce bowel movement was evaluated as related to injury level, ASIA impairment scale, and ability to voluntarily increase anorectal pressure, measured with a manometory. RESULTS: Bowel movement was successfully induced in 15 of the 20 patients (75%). Success was not related significantly to injury level, ASIA impairment scale, or ability to voluntarily squeeze. Compared with their usual manner of bowel management, for which they spent more than 30 mins, time needed for successful bowel movement was shortened in 11 of 13 patients. No complications were observed. CONCLUSIONS: This preliminary study suggests that our newly modified washing toilet seat with a monitoring system could be a useful alternative for bowel management in patients with SCI.
OBJECTIVE: The objective was to study the effectiveness of a modified washing toilet seat equipped with a CCD camera monitor and an electronic bidet to facilitate precise hitting of the anal area with water streams to stimulate bowel movement in patients with spinal cord injury (SCI). DESIGN: There were 20 subjects, all of whom had traumatic SCI, were at least 5 mos post acute injury, and could change their position on the toilet seat while watching the monitor. Stimulation of bowel movement with the modified toilet seat was provided for a maximum of 30 mins. Success or failure to induce bowel movement was evaluated as related to injury level, ASIA impairment scale, and ability to voluntarily increase anorectal pressure, measured with a manometory. RESULTS:Bowel movement was successfully induced in 15 of the 20 patients (75%). Success was not related significantly to injury level, ASIA impairment scale, or ability to voluntarily squeeze. Compared with their usual manner of bowel management, for which they spent more than 30 mins, time needed for successful bowel movement was shortened in 11 of 13 patients. No complications were observed. CONCLUSIONS: This preliminary study suggests that our newly modified washing toilet seat with a monitoring system could be a useful alternative for bowel management in patients with SCI.