title: Long-term outcome of transanal irrigation for children with spina bifida.
abstract: METHODS
  Experimental, prospective study.
  
  
  OBJECTIVE
  We evaluated the long-term clinical efficacy of transanal irrigation (TAI) and its effect on the quality of life of spina bifida children and their caregivers.
  
  
  METHODS
  Republic of Korea.
  
  
  METHODS
  Forty-four spina bifida pediatric patients with constipation, fecal incontinence or both, underwent a TAI program at our spina bifida clinic between December 2010 and October 2013. The children and their caregivers were evaluated using a self-administered questionnaire before TAI and at 3 months and 3 years after initiation of the program.
  
  
  RESULTS
  Successful treatment outcome was achieved in 38 (86.4%) children after a mean follow-up duration of 33 months (range, 30-36). The mean number of fecal incontinence episodes per week, the number of diaper changes and the total time for bowel care per day before the program decreased at the latest follow-up examination from 7.3 to 0.4 (P<0.001), 1.6 to 0.2 (P<0.001) and 29.2 to 19.4 min (P=0.038), respectively. These results remained constant from short-term follow-up at 3 months to 3 years. Caregivers and children could go out more often (P=0.002), and the emotional impact of bowel care on caregivers decreased (P<0.001). The reported mean overall satisfaction with TAI was 8/10. The common adverse effect during TAI was abdominal discomfort (60.5%).
  
  
  CONCLUSIONS
  We observed a sustained significant improvement in defecation symptoms and quality of life for 3 years in spina bifida children who underwent continuous TAI.
authors.affiliation: Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: E K
authors.initials: EK
authors.lastname: Choi
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: S W
authors.initials: SW
authors.lastname: Han
authors.affiliation: Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Shin
authors.affiliation: Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Chon
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Im