Management of Neuropathic Bowel Dysfunction with Transanal Irrigation System

Abstract

Purpose To evaluate the efficacy of the Peristeen® transanal irrigation (TI) system in children with neuropathic bowel dysfunction (NBD) Material and Methods We prospectively evaluated children with myelomeningocele and NBD who have achieved complete urinary continence (dryness in-between catheterization) but have poor bowel control. All patients were started on transanal irrigation using Peristeen® (coloplast- Denmark). The children's bowel functions, patient's and parent's satisfaction and diaper independency were evaluated. Results Forty five patients were included in our protocol (ten underwent augmentation ileocystoplasty as part of managing their neuropathic bladder). Their was 23 female and 22 male patients, mean age was 8.4 years +/− 2.4 SD (4-13 years).Average follow up period 14 months (5-20). The average frequency of usage Peristeen® system was every 3 days. 40 patients (88.8%) showed complete dryness stool wise, with no soiling, 5 patients showed partial improvement with varying degree of faecal soiling. Out of the 45 patients, 30 (68.8%) were able to switch from diapers to underwear completely and 9 (20 %) limited their use of diapers only at school or long trips. The observed adverse events were abdominal pain at the start of treatment which disappears after a short time, catheter malfunction and leakage of irrigation fluid were recorded in 4, 7 and 6 patients respectively. Conclusions In our initial experience using the Peristeen® system we found it an effective, safe, and easy applicable conservative method of bowel management in patients with NBD.