Neurogenic colorectal dysfunction - use of new antegrade and retrograde colonic wash-out methods

Objectives: To evaluate results of the Enema Continence Catheter (ECC) and the Malone Antegrade Continence Enema (MACE) applied in patients with severe neurogenic colorectal dysfunction. Methods: The ECC was offered to 21 patients (mean age 39.9, range 7-72 years). The MACE was used in eight patients (mean age 32.8 years, range 15-66 years). All patients still using the ECC or the MACE at follow-up were interviewed. Results from patients not available for follow-up were drawn from hospital records. Results: Overall success with the ECC was found in 12 of 21 patients (57%). In patients with faecal incontinence, the ECC was successful in eight out of eleven patients (73%), while four out of ten patients (40%) with constipation were successfully treated. Overall success with the MACE was found in seven out of eight patients (87%). Successful treatment with the ECC or the IMAGE was followed by significant improvement in quality of life. Conclusion: The ECC is a simple therapeutic method in severe neurogenic colorectal dysfunction. If the ECC fails the MACE, as a minor and reversible operation, is a suitable alternative to more extensive procedures.