Philip Corbett1, Amelia Denny2, Karen Dick1, Padraig S Malone2, Stephen Griffin2, Michael P Stanton3. 1. Department of Paediatric Surgery, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK. 2. Department of Paediatric Urology, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK. 3. Department of Paediatric Surgery, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK. Electronic address: mikestanton49@hotmail.com.
Abstract
OBJECTIVE: Faecal incontinence secondary to myelomeningocele, Hirschsprung disease, and anorectal anomalies remains a significant and common problem. We aimed to report our 5-year experience with the Peristeen trans-anal irrigation system (TAIS) to manage such children. PATIENTS AND METHOD: This study was a combination of a retrospective case note review and assessment using a validated quality of life questionnaire (QOL) to determine pre- and post-TAIS bowel function and continence. QOL scores and functional outcomes before and during TAIS use were compared using Wilcoxon matched pairs test (p < 0.05 significant). RESULTS: Twenty-four children (median age 6 years) were managed with the TAIS 2006-2011 to treat faecal incontinence. Three did not tolerate the system. Median QOL scores in 20 out of 21 patients using TAIS demonstrated significant improvement in bowel management and continence. Two discontinued use due to failure to improve continence; one underwent the Malone antegrade continence enema (MACE) procedure and one returned to oral/rectal medications. Nineteen of 24 patients (79%) continue to use TAIS. CONCLUSIONS: The Peristeen TAIS is an effective, safe, non-operative alternative to MACE in children with faecal incontinence, if initial compliance can be achieved.
OBJECTIVE: Faecal incontinence secondary to myelomeningocele, Hirschsprung disease, and anorectal anomalies remains a significant and common problem. We aimed to report our 5-year experience with the Peristeen trans-anal irrigation system (TAIS) to manage such children. PATIENTS AND METHOD: This study was a combination of a retrospective case note review and assessment using a validated quality of life questionnaire (QOL) to determine pre- and post-TAIS bowel function and continence. QOL scores and functional outcomes before and during TAIS use were compared using Wilcoxon matched pairs test (p < 0.05 significant). RESULTS: Twenty-four children (median age 6 years) were managed with the TAIS 2006-2011 to treat faecal incontinence. Three did not tolerate the system. Median QOL scores in 20 out of 21 patients using TAIS demonstrated significant improvement in bowel management and continence. Two discontinued use due to failure to improve continence; one underwent the Malone antegrade continence enema (MACE) procedure and one returned to oral/rectal medications. Nineteen of 24 patients (79%) continue to use TAIS. CONCLUSIONS: The Peristeen TAIS is an effective, safe, non-operative alternative to MACE in children with faecal incontinence, if initial compliance can be achieved.
Authors: Jonathan C Routh; David B Joseph; Tiebin Liu; Michael S Schechter; Judy K Thibadeau; M Chad Wallis; Elisabeth A Ward; John S Wiener Journal: J Pediatr Rehabil Med Date: 2017-12-11
Authors: S Basson; A Zani; S McDowell; E Athanasakos; S Cleeve; S Phelps; P Charlesworth Journal: Pediatr Surg Int Date: 2014-10-07 Impact factor: 1.827