Walker and Webster, 19892424 Walker J, Webster P. Successful management of faecal incontinence using the enema continence catheter. Z Kinderchir. 1989;44:44-5.
|
United Kingdom |
Descriptive Single center |
10 SB Age: 4-17 years |
- |
- |
4-30 months |
70% FI improvement |
Liptak and Revel, 19922525 Liptak GS, Revell GM. Management of bowel dysfunction in children with spinal cord disease or injury by means of the enema continence catheter. J Pediatr. 1992;120:190-4.
|
USA |
Quasi-experimental pre-test/post-test Single center |
30 MMC Age: 3-19 years |
To evaluate the catheter for continence enema created by Shandling and Gilmour. |
Satisfaction scale (0-4) |
T1=18 months T2=30 months |
55% constipation for 20% in T1 and 15% in T2 FI from 72% to 29% in T1 and 6% in T2 Satisfaction degree from 1.1 to 2.8 in T1 and 3.3 in T2 Reduced the need for diapers from 88% to 73% in T1 and 72% in T2 |
Blair, 19922626 Blair GK, Djonlic K, Fraser GC, Arnold WD, Murphy JJ, Irwin B. The bowel management tube: an effective means for controlling fecal incontinence. J Pediatr Surg. 1992;27:1269-72.
|
United Kingdom |
Quasi-experimental pre-test/post-test Single center |
19 MMC Age: 3-16 years |
Presenting patients who went through a 1-year study in the Fecal Incontinence Clinic at the British Columbia Children's Hospital. |
Satisfaction scale (0-5) |
12 months |
FI improvement in 87% |
De Kort, 19972727 de Kort LM, Nesselaar CH, van Gool JD, de Jong TP. The influence of colonic enema irrigation on urodynamic findings in patients with neurogenic bladder dysfunction. Br J Urol. 1997;80:731-3.
|
The Netherlands |
Quasi-experimental pre-test/post-test Single center |
83 SB Age: 1-17 years |
To evaluate whether colonic enema irrigation influences urodynamic characteristics of SB patients. |
- |
- |
There was no significant difference in urodynamics. |
Mattsson and Gladh, 20062828 Mattsson S, Gladh G. Tap-water enema for children with myelomeningocele and neurogenic bowel dysfunction. Acta Paediatr. 2006;95:369-74.
|
Switzerland |
Quasi-experimental pre-test/post-test Single center |
40 MMC Age: from 10 months to 11 years |
To evaluate transanal irrigation with clean tap water with no salt in children with MMC and neurogenic bowel disorders. |
- |
18 months |
100% constipation improvement Improvements in the wellbeing of the child, better appetite, less stomach ache and headache complaints. (36/40) 95% depended on their parents |
Vande Velde, 20072929 Vande Velde S, Van Biervliet S, Van Renterghem K, Van Laecke E, Hoebeke P, Van Winckel M. Achieving fecal continence in patients with spina bifida: a descriptive cohort study. J Urol. 2007;178:2640-4; discussion 2644.
|
Belgium |
Cross-sectional study Single center |
80 MMC Age: 5-18 years |
To evaluate the results of a stratified approach to reach fecal pseudocontinence in MMC patients. |
- |
- |
Pseudocontinence achieved in 69% |
Ausili, 20103030 Ausili E, Focarelli B, Tabacco F, Murolo D, Sigismondi M, Gasbarrini A, Rendeli C. Transanal irrigation in myelomeningocele children: an alternative, safe and valid approach for neurogenic constipation. Spinal Cord. 2010;48:560-5.
|
Italy |
Quasi-experimental pre-test/post-test Single center |
60 SB Age: 6-17 years |
To evaluate whether the TAI can be a safe and effective alternative approach to manage pediatric neurogenic constipation in children with MMC and to improve the intestinal habits and QoL of patients and their families. |
NBD Score Satisfaction scale (0 to 10) |
3 months |
Constipation improved in 60% FI improved in 75% NBD score from 17.5 to 8.5 (p < 0.001) Independence - 26.7% Diminution in E. coli urinary tract infections |
Vande Velde, 20133131 Vande Velde S, Van Biervliet S, Van Laecke E, De Bruyne R, Verhelst H, Hoebeke P, Van Winckel M. Colon enemas for fecal incontinence in patients with spina bifida. J Urol. 2013;189:300-4.
|
Belgium |
Prospective cohort Single center |
25 SB Age: 5-17 years |
To study the use of colon enemas to reach fecal pseudocontinence in SB patients, determining variables associated with the success. |
- |
Mean of 5 years old |
Pseudocontinence in 76% Social fecal continence in 88% Independence - 17% |
Neel, 20103232 Neel KF. Total endoscopic and anal irrigation management approach to noncompliant neuropathic bladder in children: a good alternative. J Urol. 2010;184:315-8.
|
Saudi Arabia |
Quasi- experimental pre-test/post-test |
13 SB Age: 5.3 years (median) |
To evaluate the efficacy and durability of combined intradetrusor botulinum-A toxin and endoscopic treatment for vesicoureteral reflux with anal irrigation as a total endoscopic and anal irrigation management approach. |
- |
12 months |
10 out of 13 achieved fecal continence by having TAI applied for a mean of twice a week and could stop wearing diapers. |
Donlau, 20133333 Donlau M, Mattsson S, Glad-Mattsson G. Children with myelomeningocele and independence in the toilet activity: a pilot study. Scand J Occup Ther. 2013;20:64-70.
|
Sweden |
Quasi- experimental pre-test/post-test |
22 SB Age: 3-17.2 years |
To evaluate a step-by-step method to determine goals for self-care training in bathroom activities for children with MMC. |
GAS |
-
|
The group that trained in TAI (7 patients), at first, has a median score of 30 (m32.1, range 28-41); after training, the score became 49 (m 44.6, range 32-54), also showing significant improvement (compared mean p=0.02). |
Choi, 20133434 Choi EK, Shin SH, Im YJ, Kim MJ, Han SW. The effects of transanal irrigation as a stepwise bowel management program on the quality of life of children with spina bifida and their caregivers. Spinal Cord. 2013;51:384-8.
|
South Korea |
Quasi-experimental pre-test/post-test Single center |
53 SB Age: 3 to 13.8 years |
To evaluate the clinical efficacy of a bowel management program in the QoL of SB children and their caregivers. |
Bristol Scale |
3 to 7 months |
Success in 81.1% (FI and constipation) |
Choi, 20153535 Choi EK, Han SW, Shin SH, Ji Y, Chon JH, Im YJ. Long-term outcome of transanal irrigation for children with spina bifida. Spinal Cord. 2015;53:216-20.
|
South Korea |
Quasi-experimental pre-test/post-test Single center |
44 SB Age: 3-13.8 years |
To evaluate long-term clinical efficacy of TAI and its effects on the QoL of SB children and their caregivers. |
FIQL |
T1=3 months T2=3 years |
Pseudocontinece from 35.1 to 91.9% at T1 and 89.2% at T2 Lower use of diapers, 1.6 at T1 and 0.2 at T2 FI improvement of 7.3 at T1 and 0.4 at T2 TAI satisfaction went from 8 (T1) to 10 (T2) |
King, 20173636 King SK, Stathopoulos L, Pinnuck L, Wells J, Hutson J, Heloury Y. Retrograde continence enema in children with spina bifida: not as effective as first thought. J Paediatr Child Health. 2017;53:386-90.
|
Australia |
Cross-sectional study Single center |
20 SB Age: 14.5 years (median) |
To investigate the efficacy of Peristeen® continence retrograde irrigation in children with SB. |
FIQL St. Marks FI Index Cleveland Clinic Constipation Index NBD Score
|
1-8 years |
FI and pseudocontinence improved in 8/9 patients (no significant difference) |
Ambartsumyan and Rodriguez, 201877 Ambartsumyan L, Rodriguez L. Bowel management in children with spina bifida. J Pediatr Rehabil Med. 2018;11:293-301.
|
USA |
Narrative Literature Revision |
- |
To review a step-by-step approach for bowel management in children with SB, and the challenges related with the tt options proposed. |
Cites: Pediatric NBD Score Adolescent Fecal Incontinence and Constipation Symptom Index |
6 months |
Success rate of 66-87.5%; QoL increase Constipation reduction from 92.7% to 41.5%; FI from 39.9% to 9.8%. and flatulent incontinence from 31.7% to 10%. NDB score reduction
|
Ausili, 20183737 Ausili E, Marte A, Brisighelli G, Midrio P, Mosiello G, La Pergola E, et al. Short versus mid-long-term outcome of transanal irrigation in children with spina bifida and anorectal malformations. Childs Nerv Syst. 2018;34:2471-9.
|
Italy |
Quasi-experimental time series Multicentric |
38 SB Age: 6-17 years |
To evaluate the short-to-medium term efficiency of TAI and its effect on the quality of life of children with SB and anorectal malformations. |
CHQ-PF50 for the parents and SF36 for patients from 12 to 17 years old Bristol Scale |
Minimum of 24 months |
Constipation improved in 93% (T0) FI improved from 39% (T0) to 11% (T1), and then to 17% (T2) the CHQ-PF50 showed QoL improvement SF36 showed improvement in 9 variables |
Alhazmi, 20193838 Alhazmi H, Trbay M, Alqarni N, Alyami F, Khatab A, Almannie R, et al. Long-term results using a transanal irrigation system (Peristeen®) for treatment of stool incontinence in children with myelomeningocele. J Pediatr Urol. 2019;15:34.e1-34.e5.
|
Saudi Arabia |
Cross-sectional study Single center |
109 MMC Age: 5-18 years |
To evaluate the efficacy and long-term satisfaction of TAI (Peristeen®) in children with MMC who did not respond to the FI conservative tt. |
- |
48 months |
90.4% improvement in FI |
Kelly, 20193939 Kelly MS. Malone Antegrade Continence Enemas vs. Cecostomy vs. transanal irrigation-what is new and how do we counsel our patients? Curr Urol Rep. 2019;20:41.
|
USA |
Narrative Literature Revision |
22 SB - |
Providing updated information for physicians comparing techniques (TAI, cecostomy, and Malone), which have relatively high fecal continence and satisfaction success rates. |
- |
4 years |
Mean rate of continence with TAI 77.7% (53-97% interval); Constipation improvement: 78% (interval from 53-97%) General improvement of symptoms: 84% (60-100% interval)
|
Kelly, 20204040 Kelly MS, Wiener JS, Liu T, Patel P, Castillo H, Castillo J, et al. Neurogenic bowel treatments and continence outcomes in children and adults with myelomeningocele. J Pediatr Rehabil Med. 2020;13:685-93.
|
USA |
Cross-sectional study Multicentric |
380 SB Age: 5-19 years |
To determine the continence variation and its ability to carry out tt according with the modality and the characteristics of people with MMC and IN. |
- |
- |
Continence rate of 57% with the cone - children Continence rate of 80% with Peristeen® 80% - adolescents 9.8% of children and 36.5% of adolescents were independent using the cone
|
Gibbons, 20204141 Gibbons C, Coyle D, White C, Aldridge E, Doyle M, Cascio S. Assessment of neurogenic bowel symptoms with the bowel dysfunction score in children with spina bifida: a prospective case-control study. Pediatr Surg Int. 2020;36:773-7.
|
Ireland |
Case-control |
48 SB controls Age: 3-16 years |
To compare bowel function-related quality of life in children with SB with a control group of their peers to better understand the impact of bowel management and evaluate whether QoL differs with varying bowel management strategies |
NBD Score |
- |
There was no QoL difference between bowel management strategies, including the group with no treatment (p = 0.203). Despite active bowel management, the NBD score was lower in the SB group. |
Milivojevic, 20204242 Milivojevic S, Milic N, Lazovic JM, Radojicic Z. The influence of bowel management on urodynamic findings in spina bifida children with detrusor overactivity and detrusor sphincter dyssynergia. J Pediatr Urol. 2020;16:556.e1-556.e7.
|
Servia |
Prospective cohort |
39 SB Age: mean 9.5 ± 3.7 years |
To examine the effects of bowel management on urodynamic findings in SB children with detrusor overactivity and detrusor sphincter dyssynergia. |
Roma III |
12 months |
87.2% gained complete control over constipation, 71.8% gained complete control over FI, transversal rectum diameter in echosonography <3, and absence of encopresis (p < 0.001). Intestinal control led to significant improvement in urodynamic parameters (p < 0.001). |
Van Renterghem, 20214343 Van Renterghem K, Sladkov M, Matthyssens L, Van De Putte D, Pattyn P, Van Biervliet S, et al. Prospective switch study comparing two irrigation systems for transanal irrigation in children. Acta Gastroenterol Belg. 2021;84:295-8.
|
Belgium |
Quasi-experimental pre-test/post-test Single center |
14 SB Age:3-18 years |
Comparing 2 TAI systems in children with congenital diseases. |
Bristol Scale; Satisfaction Scale (0-10) |
Minimum of 2 weeks with the cone and 2 weeks with Peristeen®
|
Use of Peristeen®: 5/7 pseudoconetinent and 2/7 socially continent; Mean satisfaction with the device 8 Cone use: 17 pseudocontinent; 4/7 socially continent; and 2 incontinent. Mean satisfaction 8
|
Pinheiro, 20212323 Pinheiro MM. Irrigação Transanal simplificada em pacientes com mielomeningocele e incontinência fecal: resultados funcionais e impacto na qualidade de vida. 2021. 80 f. Dissertação (Mestrado) - Curso de Medicina, Programa de Pós-graduação em Ciências Aplicadas À Cirurgia e À Oftalmologia, Universidade Federal de Minas Gerais, Belo Horizonte - MG. [Cited 19 Sept. 2021]. Available from: https://repositorio.ufmg.br/handle/1843/37253. https://repositorio.ufmg.br/handle/1843/...
|
Brazil |
Quasi-experimental Pre-test/post-test Single center |
19 MMC Age:3-18 years |
To evaluate TAI viability using the cone; impact on elimination function and on the QoL of MMC and FI patients, and in the family QoL. |
CHQ-PF50 (QV) Wexner FI score |
12 months |
The domains with the greatest significance and positive impact on QoLRH was “health alteration” and “global health”, after TAI
|
Furuta, 20214444 Furuta A, Suzuki Y, Takahashi R, Jakobsen BP, Kimura T, Egawa S, et al. Effects of transanal irrigation on gut microbiota in pediatric patients with spina bifida. J Clin Med. 2021;10:224.
|
Japan |
Quasi-experimental Pre-test/Post-test with non-equivalent control group Single center |
16 SB Age: 6-17 years |
To investigate changes in the bowel microbiota after TAI in patients with SB. |
Bristol Scale NBD Score
|
3 months |
Significant reduction of Faecalibacterium and Blautia, with a significant increase of Bacteroides and Roseburia (associated with immune system improvement). Constipation improvements. |