title: Predictive factors for compliance with transanal irrigation for the treatment of defecation disorders.
abstract: OBJECTIVE
  To investigate compliance with transanal irrigation (TAI) one year after a training session and to identify predictive factors for compliance.
  
  
  METHODS
  The compliance of one hundred eight patients [87 women and 21 men; median age 55 years (range 18-83)] suffering from constipation or fecal incontinence (FI) was retrospectively assessed. The patients were trained in TAI over a four-year period at a single institution. They were classified as adopters if they continued using TAI for at least one year after beginning the treatment or as non-adopters if they stopped. Predictive factors of compliance with TAI were based on pretreatment assessments and training progress. The outcomes of the entire cohort of patients who had been recruited for the TAI treatment were expressed in terms of intention-to-treat.
  
  
  RESULTS
  Forty-six of the 108 (43%) trained patients continued to use TAI one year after their training session. The patients with FI had the best results, with 54.5% remaining compliant with TAI. Only one-third of the patients who complained of slow transit constipation or obstructed defecation syndrome continued TAI. There was an overall discontinuation rate of 57%. The most common reason for discontinuing TAI was the lack of efficacy (41%). However, 36% of the patients who discontinued TAI gave reasons independent of the efficacy of the treatment such as technical problems (catheter expulsion, rectal balloon bursting, instilled water leakage or retention, pain during irrigation, anal bleeding, anal fissure) while 23% said that there were too many constraints. Of the patients who reported discontinuing TAI, the only predictive factor was the progress of the training (OR = 4.9, 1.3-18.9,P= 0.02).
  
  
  CONCLUSIONS
  The progress of the training session was the only factor that predicted patient compliance with TAI.
authors.affiliation: Clémence Bildstein, Chloé Melchior, Guillaume Gourcerol, Estelle Boueyre, Anne-Marie Leroi, INSERM U1073, Service de Physiologie Digestive, CHU Rouen, F-76000 Rouen, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Bildstein
authors.affiliation: Clémence Bildstein, Chloé Melchior, Guillaume Gourcerol, Estelle Boueyre, Anne-Marie Leroi, INSERM U1073, Service de Physiologie Digestive, CHU Rouen, F-76000 Rouen, France.
authors.forename: Chloé
authors.initials: C
authors.lastname: Melchior
authors.affiliation: Clémence Bildstein, Chloé Melchior, Guillaume Gourcerol, Estelle Boueyre, Anne-Marie Leroi, INSERM U1073, Service de Physiologie Digestive, CHU Rouen, F-76000 Rouen, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gourcerol
authors.affiliation: Clémence Bildstein, Chloé Melchior, Guillaume Gourcerol, Estelle Boueyre, Anne-Marie Leroi, INSERM U1073, Service de Physiologie Digestive, CHU Rouen, F-76000 Rouen, France.
authors.forename: Estelle
authors.initials: E
authors.lastname: Boueyre
authors.affiliation: Clémence Bildstein, Chloé Melchior, Guillaume Gourcerol, Estelle Boueyre, Anne-Marie Leroi, INSERM U1073, Service de Physiologie Digestive, CHU Rouen, F-76000 Rouen, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Bridoux
authors.affiliation: Clémence Bildstein, Chloé Melchior, Guillaume Gourcerol, Estelle Boueyre, Anne-Marie Leroi, INSERM U1073, Service de Physiologie Digestive, CHU Rouen, F-76000 Rouen, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Vérin
authors.affiliation: Clémence Bildstein, Chloé Melchior, Guillaume Gourcerol, Estelle Boueyre, Anne-Marie Leroi, INSERM U1073, Service de Physiologie Digestive, CHU Rouen, F-76000 Rouen, France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Leroi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal; D003248:Constipation / Q000628:therapy*; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D012189:Retrospective Studies; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Constipation; Fecal incontinence; Neurogenic bowel dysfunction; Obstructed defecation; Transanal irrigation