[Transanal irrigation for bowel and anorectal management in spinal cord-injured patients].
OBJECTIVE
Bowel dysfunction and disordered defecation are very common after spinal cord injury (SCI) and can have a major impact on patients' social life and quality of life. The aim of this study was to assess the safety and efficacy of transanal irrigations (TAI) in the management of Bowel dysfunction in SCI patients.


METHODS
Forty-five consecutive SCI patients using TAI were retrospectively included. TAI efficacy was assessed through Neurogenic Bowel Dysfunction (NBD) score recorded before and after 8 weeks of regular use. Possible side effects were assessed with a semi-structured questionnaire. Patients who started TAI use at least 6 months previously were contacted to assess long-term compliance, efficacy and safety of TAI.


RESULTS
After 8 weeks of regular use of TAI, the average NBD scores decreased by four points (P<0.0001) with a specific improvement in the items related to stool frequency (P: 0.036), occurrence of malaise, headache, or sweating during defecation (P: 0.043), use of drugs against constipation (P: 0.007) and frequency of fecal incontinence (P: 0.001). The main side effects were bleeding (10%) and abdominal pain (8%). At 6 months, 80% of the assessed patients had continued regular use of TAI with no particular problem.


CONCLUSIONS
This study showed good medium and long-term efficacy and safety of TAI in the management of bowel dysfunction and defecation disorders in spinal cord-injured patients.
Service de neuropérinéologie et sexologie, hôpital Henry-Gabrielle, hospices civil de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France. fourtmary@yahoo.fr
M
M
Fourtassi
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Charvier
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A
Hajjioui
L
L
Havé
G
G
Rode
D000328:Adult; D000368:Aged; D003248:Constipation / Q000209:etiology / Q000628:therapy; D003672:Defecation; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055496:Neurogenic Bowel / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D007507:Therapeutic Irrigation; D055815:Young Adult