The utility of the Malone antegrade continence enema for urologists

Urologists often manage patients with neurogenic voiding dysfunction. These patients often have neuropathic bowel dysfunction. The malone antegrade continence enema (ACE) performed synchronously with a urinary continence procedure has been successful in pediatric patients. We report preliminary experience combining the ACE with a urinary continence procedure in two adult neurogenic patients. The ACE procedure is technically easy. Both patients had a separate urinary stoma and an appendicocecostomy for their ACE. Both patients are continent of stool at their appendicocecostomy and per rectum. Both patients have stabilized their urinary tracts. Complications were minimal. The ACE may benefit adult patients with impaired bowel evacuation and may be combined with a urinary continence procedure. Urologists can easily perform the ACE.