490 ANTEGRADE CONTINENCE ENEMA PROCEDURE: IMPACT ON QUALITY OF LIFE IN PATIENTS WITH SPINAL CORD INJURY

You have accessJournal of UrologyPediatrics: Neuropathic Bladder/Reconstruction1 Apr 2013490 ANTEGRADE CONTINENCE ENEMA PROCEDURE: IMPACT ON QUALITY OF LIFE IN PATIENTS WITH SPINAL CORD INJURY Paul Smith and Ross Decter Paul SmithPaul Smith Hershey, PA and Ross DecterRoss Decter Hershey, PA View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1882AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Neurogenic bowel dysfunction resulting in severe constipation and fecal incontinence is a common sequela of spinal cord injury (SCI). The antegrade continence enema (ACE) procedure is often utilized by pediatric and reconstructive urologists to control these distressing symptoms. Quality of life (QOL) surveys have proven the ACE procedure effective in patients with spina bifida. We sought to assess the impact of the ACE procedure on QOL in patients with fecal incontinence due to SCI. METHODS We reviewed the records of patients with spinal cord injury undergoing the ACE procedure between 2003 and 2010. Patient demographics, level of injury, operative data, complications, and length of follow up were obtained from the medical record. QOL data relating to fecal incontinence were prospectively collected pre and postoperatively using a validated questionnaire (FIQL). The impact of fecal incontinence on QOL was scored in four categories using this survey: Lifestyle, coping/behavior, depression/self-perception, and embarrassment. QOL scores for each category are reported on a continuous scale of 1 to 4 with the higher score equating to a more favorable QOL. RESULTS The ACE procedure was performed on 17 patients (12 male; 5 female): 10 were paraplegic and 7 quadriplegic. The average age at the time of surgery was 33 years (6-49). Median duration of follow up was 62 months. QOL related to fecal incontinence improved significantly after surgery in all four QOL categories (Figure). QOL scores increased an average of 1.43, 1.66, 0.93, and 1.55 points in the lifestyle, coping/behavior, depression/self-perception, and embarrassment scales, respectively (p<0.001). CONCLUSIONS This is the first study to our knowledge that assesses the impact of the ACE procedure on the QOL in patients with SCI. We have shown using a validated questionnaire that the ACE procedure significantly improved QOL in these patients who are severely affected by their bowel dysfunction. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e201 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paul Smith Hershey, PA More articles by this author Ross Decter Hershey, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...