Experience with glycerin for antegrade continence enema in patients with neurogenic bowel

David I. Chu, Zarine R. Balsara, Jonathan C. Routh, Sherry S. Ross, John S. Wiener*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Purpose: Malone antegrade continence enemas are used in the management of neurogenic bowel to attain fecal continence. Several different irrigation solutions have been described but glycerin, an osmotic laxative that promotes peristalsis, has rarely been mentioned or studied. We assessed clinical outcomes in our patients with a Malone antegrade continence enema using glycerin based irrigation. Materials and Methods: We retrospectively reviewed patients with neurogenic bowel who underwent a Malone antegrade continence enema procedure between 1997 and 2011. Glycerin diluted with tap water followed by a tap water flush is our preferred irrigation protocol. Bowel regimen outcomes examined included fecal continence, emptying time, leakage from stoma, enema volume, frequency and independence. Results: Of the 23 patients with followup greater than 6 months 19 used glycerin based irrigation. Average age at surgery was 8.8 years. Patients using glycerin instilled a median of 30 ml (mean 29) glycerin and 50 ml (131) tap water. Fecal continence rate was 95% and stoma leakage rate was 16%, and only 16% of patients required daily irrigation. Conclusions: Glycerin is a viable and effective alternative irrigant for antegrade enemas of neurogenic bowel, with an excellent fecal continence rate. The volume of irrigant needed is typically less than 90 ml, which is much less than in published reports using tap water alone.

Original languageEnglish (US)
Pages (from-to)690-693
Number of pages4
JournalJournal of Urology
Volume189
Issue number2
DOIs
StatePublished - Feb 2013

Keywords

  • enema
  • fecal incontinence
  • glycerol
  • neurogenic bowel
  • spinal dysraphism

ASJC Scopus subject areas

  • Urology

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