Related Experiment Video

Updated: Aug 12, 2026

Vessel-sparing Excision and Primary Anastomosis
08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Functional results following the antegrade continence enema procedure

K R Shankar1, P D Losty, S E Kenny

  • 1Department of Paediatric Surgery, Institute of Child Health, Alder Hey Children's Hospital, University of Liverpool, UK.

The British Journal of Surgery
|August 6, 1998
PubMed

Insights

The antegrade continence enema (ACE) procedure is effective for fecal continence in children. However, wheelchair-bound children with spinal neuropathy experience poorer outcomes, highlighting the need for pre-operative assessment of sphincter function.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Urology

Background:

  • Forty children with fecal soiling underwent the antegrade continence enema (ACE) procedure.
  • Study aimed to identify factors predicting the outcome of the ACE procedure in pediatric patients.

Purpose of the Study:

  • To evaluate the effectiveness of the ACE procedure in improving fecal continence and quality of life in children.
  • To determine predictive factors for successful ACE outcomes, particularly in relation to mobility and underlying neurological conditions.

Main Methods:

  • Patients were categorized into four groups based on mobility (ambulant/wheelchair-bound) and diagnosis (spinal dysraphism/miscellaneous disorders).
  • Effectiveness was assessed via technical evaluation, quality-of-life improvement (QOLI) scores, colonic transit time (CTT), and anorectal manometry.
  • Median follow-up was 21 months.

Main Results:

  • Continence was achieved in 28 out of 40 children; 36 reported improved quality of life (mean QOLI score 3.5).
  • Wheelchair-bound children with spinal dysraphism showed significantly poorer QOLI scores, anorectal squeeze pressure, and continence.
  • Absent anorectal squeeze pressure correlated with poor outcomes.

Conclusions:

  • The ACE procedure is an effective method for achieving fecal continence.
  • Wheelchair-bound children with spinal neuropathy have a less favorable prognosis with the ACE procedure.
  • Pre-operative evaluation of incontinence etiology and sphincter function is crucial for optimizing ACE outcomes.
Abstract

More Related Videos

Retzius-Sparing Robot-Assisted Radical Prostatectomy12:10

Retzius-Sparing Robot-Assisted Radical Prostatectomy

Published on: May 19, 2022

Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis06:19

Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis

Published on: May 16, 2025

Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Endoscopic Procedures II: Colonoscopy01:25

Endoscopic Procedures II: Colonoscopy

The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
Urodynamic Studies: Uroflowmetry01:19

Urodynamic Studies: Uroflowmetry

Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...