Short versus mid-long-term outcome of transanal irrigation in children with spina bifida and anorectal malformations

Emanuele Ausili, A. Marte, G. Brisighelli, P. Midrio, G. Mosiello, E. la Pergola, L. Lombardi, B. D. Iacobelli, E. Caponcelli, M. Meroni, E. Leva, C. Rendeli

Research output: Contribution to journalArticle

Abstract

Purpose: We assessed short- and mid-long-term clinical efficacy of transanal irrigation (TAI) and its effect on the quality of life of children with spina bifida (SB) and anorectal malformations (ARM). Methods: Seventy-four pediatric patients (age 6–17 years) with SB and ARM with neurogenic bowel dysfunction were enrolled for a prospective and multicentric study. Patients were evaluated before the beginning of TAI (T0), after 3 months (T1) and after at least 2 years (range 24–32 months) (T2) using a questionnaire assessing bowel function, the Bristol scale, and two validated questionnaires on quality of life: the CHQ-PF50 questionnaire for the parents of patients aged 6–11 years and the SF36 questionnaires for patients aged between 12 and 18 years. Results: Seventy-two patients completed TAI program in T1, and 67 continued into T2. Bowel outcomes (constipation and fecal incontinence) improved in both the SB and the ARM groups in the short and mid-long term. In both groups at T1 and T2, parents and children reported an improvement in quality of life and there was a significant increase of stool form types 4 and 5 as described by the Bristol scale. Common adverse effects during the study were similar at T1 and T2 without serious complications. Conclusions: We observed a sustained improvement in bowel management and quality of life in SB and ARM children during the study, more significant in the short term than in mid-long term. To maintain success rates in the mid-long term and to reduce the dropout rate, we propose patient training and careful follow-ups.

Original languageEnglish
Pages (from-to)2471-2479
Number of pages9
JournalChild's Nervous System
Volume34
Issue number12
DOIs
Publication statusPublished - 2018

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Spinal Dysraphism
Quality of Life
Neurogenic Bowel
Parents
Fecal Incontinence
Constipation
Anorectal Malformations
Prospective Studies
Pediatrics
Surveys and Questionnaires

Keywords

  • Anorectal malformation
  • Constipation
  • Fecal incontinence
  • Quality of life
  • Spina bifida
  • Transanal irrigation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Short versus mid-long-term outcome of transanal irrigation in children with spina bifida and anorectal malformations. / Ausili, Emanuele; Marte, A.; Brisighelli, G.; Midrio, P.; Mosiello, G.; la Pergola, E.; Lombardi, L.; Iacobelli, B. D.; Caponcelli, E.; Meroni, M.; Leva, E.; Rendeli, C.

In: Child's Nervous System, Vol. 34, No. 12, 2018, p. 2471-2479.

Research output: Contribution to journalArticle

Ausili, Emanuele ; Marte, A. ; Brisighelli, G. ; Midrio, P. ; Mosiello, G. ; la Pergola, E. ; Lombardi, L. ; Iacobelli, B. D. ; Caponcelli, E. ; Meroni, M. ; Leva, E. ; Rendeli, C. / Short versus mid-long-term outcome of transanal irrigation in children with spina bifida and anorectal malformations. In: Child's Nervous System. 2018 ; Vol. 34, No. 12. pp. 2471-2479.
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AU - Ausili, Emanuele

AU - Marte, A.

AU - Brisighelli, G.

AU - Midrio, P.

AU - Mosiello, G.

AU - la Pergola, E.

AU - Lombardi, L.

AU - Iacobelli, B. D.

AU - Caponcelli, E.

AU - Meroni, M.

AU - Leva, E.

AU - Rendeli, C.

PY - 2018

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AB - Purpose: We assessed short- and mid-long-term clinical efficacy of transanal irrigation (TAI) and its effect on the quality of life of children with spina bifida (SB) and anorectal malformations (ARM). Methods: Seventy-four pediatric patients (age 6–17 years) with SB and ARM with neurogenic bowel dysfunction were enrolled for a prospective and multicentric study. Patients were evaluated before the beginning of TAI (T0), after 3 months (T1) and after at least 2 years (range 24–32 months) (T2) using a questionnaire assessing bowel function, the Bristol scale, and two validated questionnaires on quality of life: the CHQ-PF50 questionnaire for the parents of patients aged 6–11 years and the SF36 questionnaires for patients aged between 12 and 18 years. Results: Seventy-two patients completed TAI program in T1, and 67 continued into T2. Bowel outcomes (constipation and fecal incontinence) improved in both the SB and the ARM groups in the short and mid-long term. In both groups at T1 and T2, parents and children reported an improvement in quality of life and there was a significant increase of stool form types 4 and 5 as described by the Bristol scale. Common adverse effects during the study were similar at T1 and T2 without serious complications. Conclusions: We observed a sustained improvement in bowel management and quality of life in SB and ARM children during the study, more significant in the short term than in mid-long term. To maintain success rates in the mid-long term and to reduce the dropout rate, we propose patient training and careful follow-ups.

KW - Anorectal malformation

KW - Constipation

KW - Fecal incontinence

KW - Quality of life

KW - Spina bifida

KW - Transanal irrigation

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