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• W2019931165 abstract "No AccessJournal of UrologyPediatric Urology1 Jul 2005THE COLON FLAP/EXTENSION MALONE ANTEGRADE CONTINENCE ENEMA: AN ALTERNATIVE TO THE MONTI-MALONE ANTEGRADE CONTINENCE ENEMA C.D. ANTHONY HERNDON, MARK P. CAIN, ANTHONY J. CASALE, and RICHARD C. RINK C.D. ANTHONY HERNDONC.D. ANTHONY HERNDON More articles by this author , MARK P. CAINMARK P. CAIN Financial interest and/or other relationship with Boehringer Ingelheim and Sanofi. More articles by this author , ANTHONY J. CASALEANTHONY J. CASALE More articles by this author , and RICHARD C. RINKRICHARD C. RINK More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000161215.67278.99AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In situations where the appendix is not available for the Malone antegrade continence enema (MACE) procedure a Yang-Monti channel or a colon flap conduit can be created. We report our experience with colonic flap conduits used for the MACE. Materials and Methods: A total of 169 MACE procedures were performed between February 1997 and March 2003. In 11 patients 12 colon flaps or cecal extensions were used to construct the MACE conduit. Diagnoses included myelomeningocele (8 patients), caudal regression (1), sacral agenesis (1) and gunshot wound (1). Mean age at creation of MACE was 11.3 years (range 4.4 to 16.9). Seven cecal flaps, 1 descending colon flap and 4 cecal extension flaps were created. Results: Average followup was 22.8 months (range 2.6 to 34.6). Indications for colon flap MACE were appendicovesicostomy (6 patients), short appendix (2), shortened mesentery (1), retrocecal appendix (1), prior appendectomy (1) and right hemicolectomy (1). Initially all patients easily catheterized and flushed the MACE once daily. All 11 patients achieved fecal continence. Complications occurred in 3 cases. One obese patient could not visualize the umbilical stoma and it stenosed, requiring conversion to a spiral Monti-MACE. One patient with a cecal extension had development of a false passage, resulting in complete channel stenosis. One patient had development of stomal leakage, which was successfully treated with dextranomer/hyaluronic acid copolymer injection. Conclusions: A colon flap MACE conduit is a simple technique to provide access to the colon for irrigation. When faced with situations were the appendix is not available for the MACE procedure the colon flap can be a good option. References 1 : Preliminary report: the antegrade continence enema. Lancet1990; 336: 1217. Google Scholar 2 : The clinical application of the Malone antegrade colonic enema. J Pediatr Surg1993; 28: 1012. Google Scholar 3 : Combined Mitrofanoff and antegrade continence enema procedures for urinary and fecal incontinence. J Urol1997; 158: 192. Link, Google Scholar 4 : The Malone antegrade continence enema procedure in the management of patients with spina bifida. J Am Coll Surg1998; 186: 669. Google Scholar 5 : The Malone antegrade continence enema procedure: quality of life and family perspective. J Urol2003; 169: 320. Link, Google Scholar 6 : In situ Malone antegrade continence enema in 127 patients: a 6-year experience. J Urol2004; 172: 1689. Link, Google Scholar 7 : The left Monti-Malone procedure: preliminary results in seven cases. J Pediatr Surg2002; 37: 228. 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Link, Google Scholar 16 : An alternative channel for the Malone principle on the left colon: experimental and preliminary clinical experience with five patients. J Urol2002; 167: 256. abstract 1007. Google Scholar 17 : Modified cecal flap neoappendix for the Malone antegrade continence enema procedure: a novel technique. J Urol2003; 169: 2321. Link, Google Scholar 18 : Continent appendicostomy in the bowel management of fecally incontinent children. J Pediatr Surg1997; 32: 1630. Google Scholar 19 : Modified technique of antegrade continence enema using a stapling device. J Urol2000; 163: 589. Link, Google Scholar 20 : Colonic tubes for the antegrade continence enema: comparison of surgical technique. J Urol2004; 172: 700. Link, Google Scholar From the Department of Urology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byChu D, Balsara Z, Routh J, Ross S and Wiener J (2018) Experience with Glycerin for Antegrade Continence Enema in Patients with Neurogenic BowelJournal of Urology, VOL. 189, NO. 2, (690-693), Online publication date: 1-Feb-2013.Bar-Yosef Y, Castellan M, Joshi D, Labbie A and Gosalbez R (2018) Total Continence Reconstruction Using the Artificial Urinary Sphincter and the Malone Antegrade Continence EnemaJournal of Urology, VOL. 185, NO. 4, (1444-1448), Online publication date: 1-Apr-2011.Bani-Hani A, Cain M, Kaefer M, Meldrum K, King S, Johnson C and Rink R (2018) The Malone Antegrade Continence Enema: Single Institutional ReviewJournal of Urology, VOL. 180, NO. 3, (1106-1110), Online publication date: 1-Sep-2008. Volume 174Issue 1July 2005Page: 299-302 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsenemafecal incontinencecolonconstipationMetricsAuthor Information C.D. ANTHONY HERNDON More articles by this author MARK P. CAIN Financial interest and/or other relationship with Boehringer Ingelheim and Sanofi. More articles by this author ANTHONY J. CASALE More articles by this author RICHARD C. RINK More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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