Purpose: Fecal incontinence is a serious complication after repair of anorectal malformations. We investigated whether reoperation can improve fecal continence.
Methods: Medical records of 41 patients (40 children and one adult; 26 male and 15 female) who underwent reoperation after previous reconstruction of an anorectal malformation were reviewed for outcomes of bowel function. Type of primary corrective surgery performed, therapeutic measures, results of physical examination and barium enema, and reoperation procedures were evaluated. A questionnaire was administered to assess stool behaviour and level of continence at follow-up three or more years after secondary operation.
Results: Secondary operations in males comprised posterior sagittal anorectoplasty (PSARP) in 16 patients, PSARP with antegrade continent enema in one patient, antegrade continent enema alone in 6, anoplasty in one, rectosigmoid resection in 1, and definitive colostomy in 1 patient. Secondary operations in females included PSARP alone in 4 patients, PSARP with total urogenital mobilization in 4, PSARP with vaginoplasty in 2, PSARP with vaginoplasty and antegrade continent enema in 2, and PSARP with vaginourethroplasty in 3. Of 41 patients 18 (44 percent) were continent at follow-up, 21 (51 percent) were clean with use of enemas, diet, or drug therapy. One patient had a definitive colostomy. One died after kidney transplantation.
Conclusions: Surgery is a good option for improving incontinence in selected patients previously operated for anorectal malformations. Posterior sagittal anorectoplasty is advocated to improve bowel control. Antegrade continent enema is a reliable therapeutic option to maintain clean patients with fecal incontinence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/DCR.0b013e3181972333 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Single Incision Laparoscopic Surgery for Malone Antegrade Continent Enema: Optimizing Outcomes in Pediatric Bowel Management.
J Pediatr Surg
November 2024
Comprehensive Colorectal Center, Department of Surgery, Children's Mercy Kansas City, Kansas City, MO, USA; Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA. Electronic address:
Background: Malone antegrade continence enemas (MACE) are increasingly being used to manage severe constipation and fecal incontinence in children. Despite advances in minimally invasive pediatric colorectal surgery, single-incision laparoscopic surgery (SILS) for MACE creation remains relatively unexplored. This study, featuring the largest cohort to date, evaluates the feasibility, safety, and clinical outcomes of SILS MACE creation in children.
View Article and Find Full Text PDFAre buccal mucosal grafts useful for continent catheterizable channel stenosis? A French' reconstructive urology centers experience.
Fr J Urol
October 2024
Service d'urologie, CHU de Grenoble, 38700 La Tronche, France; Service d'urologie, hôpital Foch, 92150 Suresnes, France.
Introduction: Cutaneous stoma stenosis represents a frequent complication associated with continent catheterizable channel, often necessitating recurrent patients' consultation, hospital admission, and repetitive surgical interventions. Management strategies encompass dilatation, incision, and, in case of refractory stenosis, invasive surgical revision.
Objectives: In this study, we aimed to assess the efficacy of buccal mucosa graft as an alternative therapeutic approach for managing cutaneous catheterizable channel stenosis.
Self-esteem and quality of life in patients with neurogenic dysfunction and continent urinary diversion and/or procedures for anterograde enemas.
Actas Urol Esp (Engl Ed)
October 2023
Clínica Comfamiliar, Pereira, Colombia; Cirugía General y Cirugía Pediátrica, Sección de Cirugía Pediátrica, Departamento de Cirugía, Universidad del Valle, Cali, Colombia. Electronic address:
Introduction And Objective: The importance of evaluating the self-esteem and quality of life of patients with a chronic disease has become increasingly relevant. The study describes self-esteem and quality of life outcomes in patients with neurogenic dysfunction and continent urinary diversions and/or antegrade enema procedures.
Materials And Methods: Cross-sectional observational study, including patients with neurogenic dysfunction who required a continent urinary diversion and/or an antegrade enema conduit during their treatment.
Lower Detrusor Apron-sparing Robot-assisted Radical Cystectomy and Intracorporeal Neobladder Reconstruction: Technique and Preliminary Outcomes.
Eur Urol Focus
September 2023
Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France; Department of Urology, Institut Universitaire du Cancer-Toulouse, Oncopole (IUCT-O), Toulouse, France.
Background: Prior studies on robot-assisted laparoscopic prostatectomy (RALP) have shown that preservation of the anterior periprostatic structures is associated with good functional outcomes in terms of urinary continence and erectile function. With this in mind, we developed a technique for preservation of the lower part of the detrusor apron (LDA) and anterior periprostatic structures at the time of robot-assisted radical cystectomy (RARC) and intracorporeal neobladder (ICNB) reconstruction.
Objective: To describe our LDA-sparing RARC technique and to assess its safety and outcomes.
Medium-Term Outcomes of Antegrade Continent Enema (ACE): Cairo University Specialized Pediatric Hospital (CUSPH) Experience.
J Pediatr Surg
July 2023
Cairo University Specialized Pediatric Hospital, Cairo, Egypt. Electronic address:
Aim Of The Study: To assess the medium-term outcomes of ACE in children with fecal incontinence (FI).
Method: Eligible children were recruited from the colorectal clinic between December 2016 and January 2020 and were followed prospectively for 2-6 years. A series of questionnaires were used to assess QOL, patients and parent satisfaction, and to assess the outcomes of the ACE.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!