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Identifying predictive factors for bowel control in patients with spina bifida and spinal cord injuries

Alfredo Domínguez-Muñoz1, Luis De La Torre1, Karla Santos-Jasso2

  • 1International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Children's Hospital Colorado, Department of Surgery, School of Medicine, Anschutz Medical Campus, University of Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA.

Pediatric Surgery International
|July 11, 2023
PubMed

Insights

Urinary continence is a key predictor of bowel control in patients with Spina Bifida (SB) and Spinal Cord Injuries (SCI). Fecal incontinence is linked to VP shunts, urinary incontinence, and wheelchair use.

Area of Science:

  • Neurology
  • Pediatric Surgery
  • Rehabilitation Medicine

Background:

  • Spina Bifida (SB) and Spinal Cord Injuries (SCI) significantly impact bowel function.
  • Effective bowel management is crucial for patient quality of life.

Purpose of the Study:

  • Assess the effectiveness of a Bowel Management Program (BMP).
  • Identify predictors of bowel control in SB and SCI patients.
  • Evaluate the impact of fetal repair (FRG) on bowel control in SB.

Main Methods:

  • Retrospective analysis of 336 SB and SCI patients (2020-2023).
  • Data collected from the Multidisciplinary Spinal Defects Clinic.
  • Comparison of bowel control based on urinary continence, VP shunt, wheelchair use, and FRG.

Main Results:

  • 70% experienced fecal incontinence; 30% achieved bowel control.
  • Urinary continence strongly predicted bowel control (0% vs 100%).
  • Higher fecal incontinence rates observed with VP shunts (84%), urinary incontinence (82%), and wheelchair use (79%).
  • BMP success rate of 90% in achieving stool continence.
  • No significant difference in bowel control between fetal repair and non-fetal repair groups.

Conclusions:

  • Urinary continence is a reliable predictor of bowel control in SB and SCI.
  • VP shunt, urinary incontinence, and wheelchair use are risk factors for fecal incontinence.
  • Fetal repair did not demonstrate a significant impact on bowel or urinary control in this cohort.
Abstract

Keywords:
Bowel management programFecal continenceFecal incontinenceFetalSpina bifidaSpinal cord injury

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