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Peristeen integrated transanal irrigation system successfully treats faecal incontinence in children
Philip Corbett1, Amelia Denny2, Karen Dick1
1Department of Paediatric Surgery, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK.
Insights
The Peristeen trans-anal irrigation system (TAIS) effectively manages faecal incontinence in children with complex conditions, significantly improving quality of life and continence for most users.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Urology
Background:
- Faecal incontinence in children with myelomeningocele, Hirschsprung disease, and anorectal anomalies is a persistent challenge.
- Management options are limited, often involving invasive procedures.
Purpose of the Study:
- To evaluate the 5-year experience with the Peristeen trans-anal irrigation system (TAIS) for managing pediatric faecal incontinence.
- To assess the impact of TAIS on bowel function, continence, and quality of life.
Main Methods:
- Retrospective case note review combined with quality of life (QOL) questionnaire assessment.
- Comparison of pre- and post-TAIS bowel management and continence using Wilcoxon matched pairs test.
Main Results:
- Twenty-four children (median age 6 years) used TAIS for faecal incontinence.
- Significant QOL and continence improvement was observed in 20 out of 21 patients.
- 19 of 24 patients (79%) continue TAIS use; 3 did not tolerate the system.
Conclusions:
- Peristeen TAIS is an effective and safe non-operative alternative for pediatric faecal incontinence.
- Successful management is contingent on achieving initial patient compliance.
- TAIS offers a viable option compared to the Malone antegrade continence enema (MACE) procedure.
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.
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