Peristeen integrated transanal irrigation system successfully treats faecal incontinence in children.
OBJECTIVE
Faecal incontinence secondary to myelomeningocele, Hirschsprung disease, and anorectal anomalies remains a significant and common problem. We aimed to report our 5-year experience with the Peristeen trans-anal irrigation system (TAIS) to manage such children.


METHODS
This study was a combination of a retrospective case note review and assessment using a validated quality of life questionnaire (QOL) to determine pre- and post-TAIS bowel function and continence. QOL scores and functional outcomes before and during TAIS use were compared using Wilcoxon matched pairs test (p < 0.05 significant).


RESULTS
Twenty-four children (median age 6 years) were managed with the TAIS 2006-2011 to treat faecal incontinence. Three did not tolerate the system. Median QOL scores in 20 out of 21 patients using TAIS demonstrated significant improvement in bowel management and continence. Two discontinued use due to failure to improve continence; one underwent the Malone antegrade continence enema (MACE) procedure and one returned to oral/rectal medications. Nineteen of 24 patients (79%) continue to use TAIS.


CONCLUSIONS
The Peristeen TAIS is an effective, safe, non-operative alternative to MACE in children with faecal incontinence, if initial compliance can be achieved.
Department of Paediatric Surgery, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK.
Philip
P
Corbett
Department of Paediatric Urology, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK.
Amelia
A
Denny
Department of Paediatric Surgery, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK.
Karen
K
Dick
Department of Paediatric Urology, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK.
Padraig S
PS
Malone
Department of Paediatric Urology, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK.
Stephen
S
Griffin
Department of Paediatric Surgery, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK. Electronic address: mikestanton49@hotmail.com.
Michael P
MP
Stanton
D000293:Adolescent; D001003:Anal Canal / Q000002:abnormalities; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000150:complications / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004733:Enema / Q000295:instrumentation* / Q000379:methods; D005242:Fecal Incontinence / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D061214:Patient Safety; D011788:Quality of Life; D012007:Rectum / Q000002:abnormalities; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
Faecal incontinence; Malone antegrade continence enema; Peristeen