Neurogenic colorectal dysfunction - use of new antegrade and retrograde colonic wash-out methods

Spinal Cord. 2000 Apr;38(4):255-61. doi: 10.1038/


Objectives: To evaluate results of the Enema Continence Catheter (ECC) and the Malone Antegrade Continence Enema (MACE) applied in patients with severe neurogenic colorectal dysfunction.

Methods: The ECC was offered to 21 patients (mean age 39.9, range 7 - 72 years). The MACE was used in eight patients (mean age 32.8 years, range 15 - 66 years). All patients still using the ECC or the MACE at follow-up were interviewed. Results from patients not available for follow-up were drawn from hospital records.

Results: Overall success with the ECC was found in 12 of 21 patients (57%). In patients with faecal incontinence, the ECC was successful in eight out of eleven patients (73%), while four out of ten patients (40%) with constipation were successfully treated. Overall success with the MACE was found in seven out of eight patients (87%). Successful treatment with the ECC or the MACE was followed by significant improvement in quality of life.

Conclusion: The ECC is a simple therapeutic method in severe neurogenic colorectal dysfunction. If the ECC fails the MACE, as a minor and reversible operation, is a suitable alternative to more extensive procedures.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Appendix / surgery
  • Catheterization / adverse effects
  • Catheterization / instrumentation
  • Catheterization / methods
  • Child
  • Colonic Diseases, Functional / etiology
  • Colonic Diseases, Functional / therapy*
  • Constipation / etiology
  • Constipation / therapy*
  • Enema / instrumentation
  • Enema / methods*
  • Fecal Incontinence / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Ostomy / adverse effects
  • Ostomy / methods
  • Patient Satisfaction
  • Rectal Diseases / etiology
  • Rectal Diseases / therapy*
  • Spinal Cord Injuries / complications*
  • Treatment Outcome