Bowel dysfunction in spina bifida--an American experience with the ACE procedure

Area of Science:

• Urology
• Colorectal Surgery
• Pediatric Surgery

Background:

• Fecal incontinence significantly impacts the quality of life for individuals with spina bifida.
• Conventional conservative management strategies are often insufficient, leading to social withdrawal.
• Neurogenic anorectal dysfunction is a common complication in spina bifida patients.

Purpose of the Study:

• To evaluate the experience and outcomes of the antegrade colonic enema (ACE) procedure in patients with spina bifida.
• To present the techniques and results of ACE procedures for managing fecal incontinence.
• To advocate for the consideration of ACE procedures in patients with neurogenic anorectal dysfunction affecting social and vocational progress.

Main Methods:

• The study involved 43 patients with spina bifida who underwent the ACE procedure.
• The report details the background, surgical techniques, and outcomes associated with these procedures.
• A review of patient data and follow-up assessments was conducted.

Main Results:

• The ACE procedure provides a new approach to managing fecal incontinence in this population.
• Experience with 43 patients demonstrates the feasibility and application of these techniques.
• Outcomes related to fecal continence and quality of life are discussed.

Conclusions:

• The antegrade colonic enema (ACE) procedure is a viable option for managing fecal incontinence in spina bifida.
• Consideration of the ACE procedure should be given to patients whose social or vocational progress is hindered by neurogenic anorectal dysfunction.
• This approach has the potential to improve overall patient well-being and integration into the social mainstream.