title: Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study.
abstract: METHODS
  Thirty-six patients with unsatisfactory treatment of neurogenic bowel dysfunctions (NBD) were enrolled from Spinal Units and Rehabilitation Centers in Italy. Treatment was for 3 weeks using a newly developed integrated system with an enema continence catheter for transanal irrigation (Peristeen, Coloplast A/S Kokkedal Denmark).
  
  
  OBJECTIVE
  To evaluate the effects of Peristeen Anal Irrigation on NBD and patient quality of life (QoL).
  
  
  METHODS
  Italy.
  
  
  METHODS
  Lesion level, ambulatory status and hand functionality were determined in all patients. NBD symptoms and QoL were evaluated before and after treatment, using a specific questionnaire. Statistical analysis was performed using McNemar Test and Sign Test.
  
  
  RESULTS
  Thirty-six patients were enrolled, and 32 patients completed the study. At the end of the treatment, 28.6% of patients reduced or eliminated their use of pharmaceuticals. Twenty-four patients became less dependent on their caregiver. There was a significant increase in patients' opinion of their intestinal functionality (P=0.001), QoL score (P=0.001) and their answers regarding their degree of satisfaction (P=0.001). A successful outcome was recorded for 68% of patients with fecal incontinence, and for 63% of patients with constipation.
  
  
  CONCLUSIONS
  Peristeen Anal Irrigation is a simple therapeutic method for managing NBD and improving QoL. It should be considered as the treatment of choice for NBD, playing a role in the neurogenic bowel analogous to that of intermittent clean catheterization in bladder treatment.
authors.affiliation: Neuro-Urology Spinal Unit, University of Florence, Florence, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Del Popolo
authors.forename: G
authors.initials: G
authors.lastname: Mosiello
authors.forename: C
authors.initials: C
authors.lastname: Pilati
authors.forename: M
authors.initials: M
authors.lastname: Lamartina
authors.forename: F
authors.initials: F
authors.lastname: Battaglino
authors.forename: P
authors.initials: P
authors.lastname: Buffa
authors.forename: T
authors.initials: T
authors.lastname: Redaelli
authors.forename: G
authors.initials: G
authors.lastname: Lamberti
authors.forename: M
authors.initials: M
authors.lastname: Menarini
authors.forename: P
authors.initials: P
authors.lastname: Di Benedetto
authors.forename: M
authors.initials: M
authors.lastname: De Gennaro
mesh_terms: D000328:Adult; D001003:Anal Canal; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000503:physiopathology; D007558:Italy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D013119:Spinal Cord Injuries / Q000150:complications; D007507:Therapeutic Irrigation / Q000379:methods; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000628:therapy*