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Retrograde continence enema in children with spina bifida: Not as effective as first thought

Sebastian K King1,2,3, Lefteris Stathopoulos1, Loreto Pinnuck4

  • 1Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia.

Journal of Paediatrics and Child Health
|November 19, 2016
PubMed

Insights

Retrograde continence enema (RCE) shows a high cessation rate in children with spina bifida. This may be due to a lack of ongoing support rather than issues with the enema itself.

Area of Science:

  • Pediatric Gastroenterology
  • Neuro-urology
  • Rehabilitation Medicine

Background:

  • Faecal incontinence is a significant challenge for children with spina bifida, impacting their quality of life.
  • Retrograde continence enema (RCE) is a management option, but its long-term effectiveness in this population is not well-established.

Purpose of the Study:

  • To evaluate the effectiveness and cessation rates of Peristeen retrograde continence enema (RCE) in managing faecal incontinence in pediatric spina bifida patients.
  • To identify factors associated with RCE cessation in this cohort.

Main Methods:

  • A homogenous group of spina bifida patients initiated on RCE between January 2006 and July 2013 were identified.
  • Assessments included Fecal Incontinence Quality Of Life (FIQOL), St Marks Faecal Incontinence score, Cleveland Clinic Constipation score, and Neurogenic Bowel Dysfunction score.

Main Results:

  • Nine out of 20 patients (mean age 14.5 years) were still using RCE at a mean follow-up of 4.1 years.
  • High cessation rates were observed, with reasons including balloon difficulties, procedural complexity, and pain.
  • No significant differences were found in training time, fluid volume, or procedure duration between users and non-users.

Conclusions:

  • A high rate of cessation of RCE was observed in children with spina bifida.
  • Cessation was not explained by associated conditions or enema-specific parameters.
  • Lack of ongoing outpatient support may contribute to RCE discontinuation.
Abstract

Keywords:
Peristeenfaecal incontinenceretrograde continence enemaspina bifida

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