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. 1994 Feb;70(2):107–110. doi: 10.1136/adc.70.2.107

Continence in patients with spina bifida: long term results.

P S Malone 1, R A Wheeler 1, J E Williams 1
PMCID: PMC1029710  PMID: 8129429

Abstract

One hundred and forty four questionnaires relating to bladder and bowel control were sent to a random selection of patients with spina bifida throughout the United Kingdom. One hundred and seventeen questionnaires were returned, of which 109 were usable. Twenty eight out of 109 responders had undergone some form of urinary diversion, of whom 20 (71%) were reliably dry. The remaining 81 responders emptied their bladders by a variety of techniques including normal voiding, straining, expression, clean intermittent catheterisation, indwelling catheters, or they dribbled urine continuously. Only 31 (38%) of this group were reliably dry. Ninety four of 109 (86%) responders regularly sat on the toilet to evacuate their bowels and most used some aid such as manual evacuation, laxatives, suppositories, or enemas. Fifty five of 104 (53%) responders soiled regularly, 31 (56%) of whom were also wet. Forty seven per cent of dry patients (24/51) were faecally incontinent. Only 25 of 104 (24%) patients responding to all questions were reliably clean and dry.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Borzyskowski M., Mundy A. R., Neville B. G., Park L., Kinder C. H., Joyce M. R., Chantler C., Haycock G. B. Neuropathic vesicourethral dysfunction in children. A trial comparing clean intermittent catheterisation with manual expression combined with drug treatment. Br J Urol. 1982 Dec;54(6):641–644. doi: 10.1111/j.1464-410x.1982.tb13615.x. [DOI] [PubMed] [Google Scholar]
  2. Elder D. D., Moisey C. U., Rees R. W. A long-term follow-up of the colonic conduit operation in children. Br J Urol. 1979 Dec;51(6):462–465. doi: 10.1111/j.1464-410x.1979.tb03579.x. [DOI] [PubMed] [Google Scholar]
  3. Hill J. T., Ransley P. G. The colonic conduit: a better method of urinary diversion? Br J Urol. 1983 Dec;55(6):629–631. doi: 10.1111/j.1464-410x.1983.tb03391.x. [DOI] [PubMed] [Google Scholar]
  4. Husmann D. A., McLorie G. A., Churchill B. M. Nonrefluxing colonic conduits: a long-term life-table analysis. J Urol. 1989 Nov;142(5):1201–1203. doi: 10.1016/s0022-5347(17)39028-6. [DOI] [PubMed] [Google Scholar]
  5. Lapides J., Diokno A. C., Silber S. J., Lowe B. S. Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol. 1972 Mar;107(3):458–461. doi: 10.1016/s0022-5347(17)61055-3. [DOI] [PubMed] [Google Scholar]
  6. Malone P. S., Ransley P. G., Kiely E. M. Preliminary report: the antegrade continence enema. Lancet. 1990 Nov 17;336(8725):1217–1218. doi: 10.1016/0140-6736(90)92834-5. [DOI] [PubMed] [Google Scholar]
  7. Mitrofanoff P. Cystostomie continente trans-appendiculaire dans le traitement des vessies neurologiques. Chir Pediatr. 1980;21(4):297–305. [PubMed] [Google Scholar]
  8. Mundy A. R., Borzyskowski M., Saxton H. M. Videourodynamic evaluation of neuropathic vesicourethral dysfunction in children. Br J Urol. 1982 Dec;54(6):645–649. doi: 10.1111/j.1464-410x.1982.tb13616.x. [DOI] [PubMed] [Google Scholar]
  9. Nurse D. E., Britton J. P., Mundy A. R. Relative indications for orthotopic lower urinary tract reconstruction, continent urinary diversion and conduit urinary diversion. Br J Urol. 1993 May;71(5):562–565. doi: 10.1111/j.1464-410x.1993.tb16025.x. [DOI] [PubMed] [Google Scholar]
  10. Shandling B., Gilmour R. F. The enema continence catheter in spina bifida: successful bowel management. J Pediatr Surg. 1987 Mar;22(3):271–273. doi: 10.1016/s0022-3468(87)80345-7. [DOI] [PubMed] [Google Scholar]
  11. Squire R., Kiely E. M., Carr B., Ransley P. G., Duffy P. G. The clinical application of the Malone antegrade colonic enema. J Pediatr Surg. 1993 Aug;28(8):1012–1015. doi: 10.1016/0022-3468(93)90505-f. [DOI] [PubMed] [Google Scholar]
  12. Wheeler R. A., Malone P. S. Use of the appendix in reconstructive surgery: a case against incidental appendicectomy. Br J Surg. 1991 Nov;78(11):1283–1285. doi: 10.1002/bjs.1800781103. [DOI] [PubMed] [Google Scholar]
  13. Wyndaele J. J., Maes D. Clean intermittent self-catheterization: a 12-year followup. J Urol. 1990 May;143(5):906–908. doi: 10.1016/s0022-5347(17)40132-7. [DOI] [PubMed] [Google Scholar]

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