Abstract
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction I1 Apr 2017MP85-14 PERISTEEN TRANSANAL IRRIGATION SYSTEM FOR THE TREATMENT OF NEUROPATHIC BOWEL DYSFUNCTION AND ABDOMINAL PAIN Giovanni Palleschi, Antonio Luigi Pastore, Yazan Al Salhi, Andrea Fuschi, Gennaro Velotti, Antonino Leto, Vincenzo Petrozza, and Antonio Carbone Giovanni PalleschiGiovanni Palleschi More articles by this author , Antonio Luigi PastoreAntonio Luigi Pastore More articles by this author , Yazan Al SalhiYazan Al Salhi More articles by this author , Andrea FuschiAndrea Fuschi More articles by this author , Gennaro VelottiGennaro Velotti More articles by this author , Antonino LetoAntonino Leto More articles by this author , Vincenzo PetrozzaVincenzo Petrozza More articles by this author , and Antonio CarboneAntonio Carbone More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2676AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transanal irrigation of the rectum (TAI) and colon is designed to assist the evacuation of faeces fromthe bowel by introducing water into these compartments via the anus. Patients with neurologic bowel disease experience not only the discomfort of an irregular bowel clearance but also very often chronic abdominal pain which limits social activities.Data fromliterature have already shown the efficacy of TAI on improving bowel emptying but there is a lack regarding the contribute of this system on reducing abdominal pain. The aim of this study was to evaluate if the use of TAI for neuropathic constipation could also relief symptoms in those subjects with associated chronic abdominal pain. METHODS A prospective study was conducted on the first cohort of adult patients affected with spinal cord lesions and neuropathic bowel dysfunction referred to our centre for Peristeen TAI treatment between July 2013 and November 2014. Patients with neurogenic bowel disturbance who did not satisfactorily respond to conventional bowel management were enroled. In particular, patients were selected following the directions of consensus review of best practice of TAI in adults. After providing informed written consent, a previously described and validated Neurogenic Bowel Dysfunction score (NBD) was used to assess bowel function. Abdominal pain was evaluated by a Visual Analogic Scale (VAS), from0¼no discomfort to 10¼severe discomfort. This questionnaires were administered before and after treatment. Peristeen TAI composed of a coated rectal balloon catheter, manual pump and water container. After the first visit in which it was determined if the patients could receive treatment and trained, they performed treatment every day per 10 days, then on alternate days. RESULTS Twenty patients were referred for Peristeen TAI during the study period. Mean time of using Peristeen TAI was 10 months and mean length of follow-up was about 3 months. All patients were noted to have an improvement in their chronic neuropathic constipation and abdominal pain, increasing in quality of life scores. VAS and NBD score were significantly different before and after. In particular, before treatment patients scored at VAS a mean value of 7.64± 0.29, while aftertreatment they scored a mean 3.64± 0.29 ; NBD score before treatment showed a mean value of 23.28± 3.14 and post-treatment of 1,92± 0.76. CONCLUSIONS In this study, TAI appears to be a safe and effective bowel management system, which improves bowel function and quality of life in patients affected with chronic neuropathic constipation. Abdominal pain, evaluated through VAS, decreases significantly with satisfaction of the patients. Comprehensive training of the patient is central to a safe and efficient long term use of TAI. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1153 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Giovanni Palleschi More articles by this author Antonio Luigi Pastore More articles by this author Yazan Al Salhi More articles by this author Andrea Fuschi More articles by this author Gennaro Velotti More articles by this author Antonino Leto More articles by this author Vincenzo Petrozza More articles by this author Antonio Carbone More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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