title: The influence of colonic enema irrigation on urodynamic findings in patients with neurogenic bladder dysfunction.
abstract: OBJECTIVE
  To evaluate whether colonic enema irrigation influences the urodynamic characteristics of patients with spina bifida, an overactive bladder and detrusor sphincter dyssynergia (DSD).
  
  
  METHODS
  Since 1991, 83 patients with spina bifida at our institution have treated their bowel dysfunction by colonic irrigation every 24-48 h. In 12 patients (seven boys and five girls, mean age 7.7 years, range 0.7-13.8) with an overactive bladder and DSD, urodynamic studies of the bladder before and after enema treatment were available with no intercurrent changes in urological therapy.
  
  
  RESULTS
  There were no significant changes overall in bladder capacity, leak-point pressure, bladder compliance and bladder instability in the selected group of children.
  
  
  CONCLUSIONS
  Although enema therapy for bowel treatment in patients with spina bifida gave good results for faecal incontinence, with good patient compliance, no favourable effect on bladder function should be expected in most patients with a high-risk urinary tract dysfunction. Further study is needed to determine factors in patients who will benefit urologically from enema treatment.
authors.affiliation: Paediatric Renal Centre, University Hospital for Children and Youth, University of Utrecht, The Netherlands.
authors.forename: L M
authors.initials: LM
authors.lastname: de Kort
authors.forename: C H
authors.initials: CH
authors.lastname: Nesselaar
authors.forename: J D
authors.initials: JD
authors.lastname: van Gool
authors.forename: T P
authors.initials: TP
authors.lastname: de Jong
mesh_terms: D002648:Child; D002675:Child, Preschool; D003106:Colon; D004733:Enema / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016135:Spinal Dysraphism / Q000150:complications* / Q000503:physiopathology; D007507:Therapeutic Irrigation; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics