Achieving Fecal Continence in Patients With Spina Bifida: A Descriptive Cohort Study

Velde, Saskia Vande; Biervliet, S. Van; Renterghem, Katrien Van; Laecke, Erik Van; Hoebeke, Piet; Winckel, Myriam Van

doi:10.1016/j.juro.2007.07.060

Cited by 65 publications

(28 citation statements)

References 16 publications

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“…Success of treatment is not related to level of spinal lesion or degree of mobility. 10 Through regular bowel enemas, laxative use and dietary modification all patients could be kept pseudo bowel continent. Prompt detection of children with high-risk urological dysfunction and early intervention is key in protecting against hydronephrosis, preserving renal function and preventing the development of a poorly compliant bladder.…”

Section: Discussionmentioning

confidence: 99%

Study of clinical profile and associated anamalies and surgical outcome of spina bifida

2017

Int Surg J

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Background: Neural tube defects (NTDs) are a group of congenital anomalies characterized by defects in dorsal midline structures, including neural tissue, dura, muscle, bone and/or skin. The clinical presentations and the followup of these patients require attention to various end organs besides the nervous system. The aim was to evaluate the clinical profile and surgical outcome of children with spina bifida. Methods: Out of a total of 74 patients treated at our institute for spina bifida between June 2013 to August 2015, 74 cases of spina bifida were analyzed retrospectively and prospectively. The clinical profile, radiological findings and urodynamic studies were recorded. Craniospinal MRI was done in patients to screen for Arnold Chiari malformations and monitoring of hydrocephalus was done as a management protocol at our institute for these children. All these patients except two underwent surgery for correction and closure of the spinal defect. Associated anomalies were treated accordingly. They were clinically assessed over a mean follow up period of 11months ranging from 2months to 2 ½ years. Results: 73% of the patients presented in the neonatal age group. Of which, 72% presented with a visible sac over the back.72% of the cases were myelomeningocoeles. 79% of the defects were in the lumbosacral region. 30% presented with sensorimotor loss or bladder bowel incontinence. Sensorimotor improvement was seen in 12.5% after repairing the defect with the help of physiotherapy and braces. 30% of the patients were diagnosed to have hydrocephalus, of which 33% required a CSF diversion procedure. The postoperative course of spina bifida repair was found to be uneventful in 90% of the patients. Conclusions: A multidisciplinary approach is required to address this disease. Early diagnosis, surgical management and rehabilitation can prevent further neurological damage and can improve quality of life in patients with spina bifida.

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Section: Discussionmentioning

confidence: 99%

Study of clinical profile and associated anamalies and surgical outcome of spina bifida

2017

Int Surg J

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“…[5] Patients with spinal problems, such as tethered cord, presacral tumor, or injuries, can lack voluntary bowel movement ability. [6] …”

Section: Introductionmentioning

confidence: 99%

Bowel management program for pediatric postoperative fecal incontinence in China

Wang

Liang²,

Wu³

et al. 2017

Medicine

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The purpose of this article is to report the status of the efficacy of and long-term adherence to the Bowel Management Program (BMP) for fecal incontinence (FI) postoperation in China.Children over 3 years of age with FI postoperation referred to our medical center were included in the study. Evaluations were performed before and 2 years after their clinic visit. The cost of bowel care, improvement in incontinence, health-related quality of life, and family functioning with the BMP were analyzed.A total of 48 children with FI were included in our study, of whom 38 were boys. The median treatment fee was 660.1 dollars. The complications included abdominal pain (4 patients, 8%), occasional vomiting (2 patients, 4%), and hypoglycemia (1 patient, 2%). The incontinence status and health-related quality of life improved significantly after the BMP. Despite the good outcome of the BMP, half of the patients discontinued the program.The BMP is an effective approach to manage FI and improve the patients’ quality of life. Poor long-term adherence is currently the main challenge affecting the BMP application in China.

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“…There are studies indicating an association between presence of spinal dysraphism and faecal incontinence or constipation [14, 15]. Some aspects of these functional disorders are in direct correlation with status of OAS integrity and function.…”

Section: Discussionmentioning

confidence: 99%

Distribution of affected muscles and degree of neurogenic lesion in patients with spina bifida

Petronić¹,

Nikolić²,

Ćirović³

et al. 2011

aoms

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IntroductionPatients with spina bifida in the lumbosacral region usually have various degrees of motor and sensory dysfunctions of the lower extremities and anal sphincter. The aim of our study was to evaluate the distribution and differences in frequencies of affected muscles, number of affected muscles and degree of neurogenic lesion between patients with spina bifida occulta (SBO) and spina bifida aperta (SBA).Material and methodsIn 100 patients with SB, 6 muscles in the lower limbs were separately analysed. Due to the number of affected muscles, we evaluated 5 groups of patients: with 1 affected muscle, 2 affected muscles, 3 affected muscles, 4 affected muscles and 5 affected muscles. Three degrees of neurogenic lesions were assessed: mild, moderate and severe.ResultsThe tibialis anterior muscle was most frequently affected in SB patients. The outer anal sphincter was frequently affected in the group of SBA patients. Single muscle affection is frequent in the group of patients with SBO, while in the group of patients with SBA, 4 muscles were significantly frequently affected. The great majority of patients (45.46%) with affected outer anal sphincter (OAS) in the group of SBO were without affection of other muscles, while for the SBA group it was for every third patient. Mild neurogenic lesion was significantly frequent in SBO patients, while severe form was significantly frequent in SBA patients.ConclusionsPatients with SBO usually present with mild to moderate clinical presentation, while multiple root involvement and severe degree of neurogenic lesion is associated more frequently with SBA.

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Achieving Fecal Continence in Patients With Spina Bifida: A Descriptive Cohort Study

Abstract: Fecal pseudo-continence was achieved in 58 of 80 patients (72.5%) with myelomeningocele.

Cited by 65 publications

References 16 publications

Study of clinical profile and associated anamalies and surgical outcome of spina bifida

Study of clinical profile and associated anamalies and surgical outcome of spina bifida

Bowel management program for pediatric postoperative fecal incontinence in China

Distribution of affected muscles and degree of neurogenic lesion in patients with spina bifida

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