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• W2079486512 abstract "No AccessJournal of UrologyMitranoff, Malone and Monti Principles1 Jun 2001THE MALONE ANTEGRADE COLONIC ENEMA ISOLATED OR ASSOCIATED WITH UROLOGICAL INCONTINENCE PROCEDURES: EVALUATION FROM PATIENT POINT OF VIEW M.O. BAU, S. YOUNES, A. AUPY, M. BERNUY, M.J. ROUFFET, D. YEPREMIAN, and H.B. LOTTMANN M.O. BAUM.O. BAU More articles by this author , S. YOUNESS. YOUNES More articles by this author , A. AUPYA. AUPY More articles by this author , M. BERNUYM. BERNUY More articles by this author , M.J. ROUFFETM.J. ROUFFET More articles by this author , D. YEPREMIAND. YEPREMIAN More articles by this author , and H.B. LOTTMANNH.B. LOTTMANN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66214-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Fecal and urinary incontinence in patients with congenital or acquired spinal cord defects represents a handicap that impairs chances of integration in society. Associated with the management of urinary incontinence, the Malone antegrade colonic enema is a generally successful procedure for resolving refractory fecal incontinence. We report the results of the evaluation of this technique from the patient perspective. Materials and Methods: A survey was conducted among 19 patients who had undergone a Malone procedure, combined in 14 with urological surgical intervention for urinary incontinence. Patients completed a questionnaire either by mail or during an interview with a urotherapy nurse and/or a psychologist. Questions concerned patient opinion about the quality of preoperative information, perioperative period, stoma, functional result and overall satisfaction. The psychological impact of the procedure was also evaluated during the interviews. No complication occurred related to the Malone procedure or stomal stenosis, and a perfect functional result was achieved in 17 patients, 1 of whom had occasional leakage through the stoma. Results: Of the 19 patients in the study 2 who have abandoned using the Malone procedure, including 1 with a poor result and 1 with a good functional result, did not return the questionnaire. The remaining 17 patients believed they had received adequate preoperative information and expressed no specific complaint about the perioperative period. The 15 with the stoma in the umbilicus were satisfied, although 3 young patients were temporarily disturbed by catheterizing the umbilicus and 2 with the stoma in the right fossa iliaca were disappointed. The 15 patients who had a perfect functional result recognized great improvement in quality of life but 13 complained of pain (12) and/or excessive duration of the procedure (9). The patient with a poor functional result and the other with occasional stomal leakage would not consider the procedure again. These 2 patients had durable postoperative depression while 3 others who ultimately achieved a good functional result experienced temporary depression. Conclusions: The Malone procedure generally meets the expectations of patients but it is considered by a majority as painful and lengthy. The umbilicus is the preferred stoma site but may prove to be disturbing in young patients. Abandonment of the procedure and postoperative depression experienced by some patients, despite a good functional result, deserve better prevention. References 1 : Preliminary report: the antegrade continence enema. Lancet1990; 336: 1217. 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Bray L, Callery P and Kirk S (2012) A qualitative study of the pre-operative preparation of children, young people and their parents’ for planned continence surgery: experiences and expectationsJournal of Clinical Nursing, 10.1111/j.1365-2702.2011.03996.x, VOL. 21, NO. 13-14, (1964-1973), Online publication date: 1-Jul-2012. MacLellan D and Bauer S (2012) Neuropathic Dysfunction of the Lower Urinary Tract Campbell-Walsh Urology, 10.1016/B978-1-4160-6911-9.00128-6, (3431-3456.e8), . Ok J and Kurzrock E (2011) Objective measurement of quality of life changes after ACE Malone using the FICQOL surveyJournal of Pediatric Urology, 10.1016/j.jpurol.2011.02.012, VOL. 7, NO. 3, (389-393), Online publication date: 1-Jun-2011. Malone P (2010) FECAL INCONTINENCE IN PEDIATRIC UROLOGY Pediatric Urology, 10.1016/B978-1-4160-3204-5.00061-X, (789-796), . Arango rave M, Linace varela L, Salazar sanín C, Hoyos figueroa F, Hurtado S and Rendón isaza J (2009) Resultados del uso de la técnica de mitrofanoff en pacientes con disfunción neurógena de la vejiga: análisis de la experiencia en el hospital universitario san vicente de paulActas Urológicas Españolas, 10.1016/S0210-4806(09)74005-7, VOL. 33, NO. 1, (69-75), Online publication date: 1-Jan-2009. (2009) Bibliography Hinman's Atlas Of Pediatric Urologic Surgery, 10.1016/B978-0-7216-0645-3.00176-1, (873-923), . Nanigian D, Nguyen T, Tanaka S, Cambio A, DiGrande A and Kurzrock E (2008) Development and Validation of the Fecal Incontinence and Constipation Quality of Life Measure in Children With Spina BifidaJournal of Urology, VOL. 180, NO. 4S, (1770-1773), Online publication date: 1-Oct-2008. Rajimwale A and Malone P (2006) The Malone antegrade continence enema (MACE) procedure Pediatric Surgery and Urology, 10.1017/CBO9780511545757.034, (429-434) Marshall D, Steinbrecher H and Malone P The Antegrade Continence Enema Procedure: Long-Term Results Pediatric Neurogenic Bladder Dysfunction, 10.1007/3-540-30867-9_34, (263-270) Liard A, Elbaz F and Bachy B Management of Constipation in Neurogenic Bladder Dysfunction Pediatric Neurogenic Bladder Dysfunction, 10.1007/3-540-30867-9_33, (257-262) Teichman J, Zabihi N, Kraus S, Harris J and Barber D (2003) Long-term results for malone antegrade continence enema for adults with neurogenic bowel diseaseUrology, 10.1016/S0090-4295(02)02282-3, VOL. 61, NO. 3, (502-506), Online publication date: 1-Mar-2003. YERKES E, CAIN M, KING S, BREI T, KAEFER M, CASALE A and RINK R (2003) The Malone Antegrade Continence Enema Procedure: Quality of Life and Family PerspectiveThe Journal of Urology, 10.1097/00005392-200301000-00096, (320-323), Online publication date: 1-Jan-2003. YERKES E, CAIN M, KING S, BREI T, KAEFER M, CASALE A and RINK R (2018) The Malone Antegrade Continence Enema Procedure: Quality of Life and Family PerspectiveJournal of Urology, VOL. 169, NO. 1, (320-323), Online publication date: 1-Jan-2003. Nijman R (2001) Neurogenic and non-neurogenic bladder dysfunctionCurrent Opinion in Urology, 10.1097/00042307-200111000-00004, VOL. 11, NO. 6, (577-583), Online publication date: 1-Nov-2001. Volume 165Issue 6 Part 2June 2001Page: 2399-2403 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsappendixfecal incontinenceenemastomasumbilicusMetricsAuthor Information M.O. BAU More articles by this author S. YOUNES More articles by this author A. AUPY More articles by this author M. BERNUY More articles by this author M.J. ROUFFET More articles by this author D. YEPREMIAN More articles by this author H.B. LOTTMANN More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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