title: The role of the retrograde colonic enema in children with spina bifida: is it inferior to the antegrade continence enema?
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of the retrograde colonic enema relative to the Malone antegrade continence enema.
  
  
  METHODS
  We retrospectively investigated 25 children with spina bifida and fecal incontinence. Thirteen children had started retrograde colonic enema and twelve had started Malone antegrade continence enema. Fecal continence, water volume, time to washout, procedure frequency, pain during procedure, performance independence and demographical data were compared between the two groups.
  
  
  RESULTS
  Fecal continence was achieved for 10 of 13 (76.9%) in the retrograde group and 9 of 12 (75.0%) in the antegrade group. In the antegrade group 8 of 12 (66.7%) performed procedure independently, while 3 of 13 (23.1%) did so in the retrograde group. Achievement of fecal continence did not differ between the groups, but procedure independence was significantly better in the antegrade group.
  
  
  CONCLUSIONS
  Our results suggest that retrograde colonic enema was not inferior to Malone antegrade continence enema on fecal continence. We recommend considering retrograde colonic enema prior to introduction of Malone antegrade continence enema in children with spina bifida.
authors.affiliation: Department of Urology, Kanagawa Children's Medical Center, 2-138-4, Mutsukawa, Minami-ku, Yokohama, 232-8555, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsuno
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shiroyanagi
authors.forename: Nobufumi
authors.initials: N
authors.lastname: Ueda
authors.forename: Mari
authors.initials: M
authors.lastname: Suzuki
authors.forename: Morihiro
authors.initials: M
authors.lastname: Nishi
authors.forename: Ayako
authors.initials: A
authors.lastname: Hagiwara
authors.forename: Terumi
authors.initials: T
authors.lastname: Ichiroku
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004733:Enema / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016135:Spinal Dysraphism / Q000150:complications*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult