The Malone Antegrade Continence Enema: Single Institutional Review

Bani-Hani, Ahmad H.; Cain, Mark P.; Kaefer, Martin; Meldrum, Kirstan K.; King, Shelly; Johnson, Cynthia S.; Rink, Richard C.

doi:10.1016/j.juro.2008.05.062

Cited by 70 publications

(54 citation statements)

References 20 publications

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“…Other tubular structures have also been proposed as CCC alternatives when the appendix is not available, including a fallopian tube, the ureter or a short segment of retubularized small bowel (the Monti technique). [5][6][7][11][12][13][14][15][16][17] CIC with a CCC enabled further development of reconstructive urology by applying the ideas of Jan Mikulicz-Radecki, a surgeon based in Wrocław, Poland, who in 1899 was the first to describe the use of parts of the digestive tract for bladder reconstruction. 18 The mean age of the children in the present study was 9.4 years, similar to those in the studies by VanderBrink et al, Bani-Hani et al and Süzer et al 5,12,13 In the majority of cases the bladder and bowel dysfunctions were caused by meningomyelocele.…”

Section: Discussionmentioning

confidence: 99%

“…Those observations are consistent with other studies. 6,[12][13][14] In the present study, CCCs for bladder CIC were created from the appendix in the majority of the patients (128), in 19 children they were formed from a divided appendix, and 5 Monti tubes were constructed. Similar ratios were reported by Süzer and Castellan.…”

Section: Discussionmentioning

confidence: 99%

“…The results of the present study are comparable with those from the literature, but with a lower incidence of stomal stenosis. [12][13][14]16,17,23,24 Narayanaswamy et al suggested that 26% of patients with appendicovesicostomy and 60% of patients with ileovesicostomy have difficulty with catheterization. 24 To avoid complications of stenosis, the current authors suggest not reversing the appendix for CVS and MACE.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Continent catheterizable conduits in pediatric urology: One-center experience

Kroll¹,

Gajewska²,

Zachwieja³

et al. 2017

Adv Clin Exp Med

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Continent catheterizable conduits in pediatric urology: One-center experience

Kroll¹,

Gajewska²,

Zachwieja³

et al. 2017

Adv Clin Exp Med

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show abstract

“…9 Since Malone and colleagues presented a preliminary report of an antegrade colonic enema (Malone antegrade continence enema [MACE]) procedure in 1990, 10 it has gained wide acceptance by urologists as a successful treatment for intractable neuropathic bowel dysfunction. [11][12][13][14][15][16] However, the MACE procedure is an invasive operation with a relatively high incidence of complications. [12][13][14][15][16] In recent years, transanal irrigation (TAI) has become a popular option in the management of NBD due to its successful results and acceptable safety profile.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14][15][16] However, the MACE procedure is an invasive operation with a relatively high incidence of complications. [12][13][14][15][16] In recent years, transanal irrigation (TAI) has become a popular option in the management of NBD due to its successful results and acceptable safety profile. [17][18][19][20][21][22][23] TAI has been suggested as a first-line therapy for children with neuropathic bowel dysfunction who do not respond to conservative medical therapy.…”

Section: Introductionmentioning

confidence: 99%

Peristeen anal irrigation as a substitute for the MACE procedure in children who are in need of reconstructive bladder surgery

Alenezi¹,

Alhazmi²,

Trbay³

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(1-2):e12-5. http://dx.doi.org/10.5489/cuaj.1263 Published online January 14, 2014. AbstractIntroduction: We evaluate the efficacy of the Peristeen (Coloplast A/S, Kokkedal, Denmark) transanal irrigation (TAI) system, as a stool cleansing mechanism, to gain stool continence in children who need reconstructive bladder surgery and have fecal incontinence. Methods: We prospectively evaluated children with neuropathic bladder and bowel dysfunction who were intended for reconstructive bladder surgery and the Malone antegrade continence enema (MACE) procedure. All patients were started on the Peristeen TAI system at least 3 months before surgery to assess their response. Each patient's bowel function, frequency of using the system, satisfaction (and that of their parents) and diaper independency were evaluated before and after reconstructive surgery. Results: We included 18 patients (11 female, 7 male) who were evaluated from April 2006 to the present. The mean age of the group was 7.6 years (range: 4-15). Fifteen patients (83.3%) showed complete dryness from stools. Of the 15 patients, 8 (53.3%) were able to be diaper-free, while 6 continued wearing diapers due to fear of soiling and 1 due to urinary incontinence. The patients underwent reconstructive bladder surgery and continued to use the Peristeen TAI system with the same results postoperatively. The main limitation of this study is the small number of patients included, although this is a very specific patient group. Conclusion: Our initial results suggest that the Peristeen TAI system is a successful conservative substitute for the MACE procedure in children who require reconstructive bladder surgery.

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Urologic management of spina bifida

Clayton

Brock

Joseph

2010

Dev Disabil Res Revs

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The urologist plays an important role in the multidisciplinary team of physicians who provide care for patients with spina bifida. We review common strategies for managing the urinary tract in these patients. The primary objective in all phases of life is protecting kidney function by minimizing bladder hostility and establishing a good capacity, low-pressure urinary reservoir. Ensuring adequate bladder and bowel continence is also paramount for enhancing self-esteem and independence. Medical therapy incorporating clean intermittent catheterization and antimuscarinic medication is the cornerstone of neurogenic bladder management and often the only intervention required to achieve the above goals. Others may require formal lower urinary tract reconstruction to prevent urinary tract deterioration. As will be shown, current management, while effective, is not supported by strong evidence-based protocols; and the impact of any intervention upon quality of life, while subjectively seen as positive, does not have objective validation. These limitations are recognized and currently the subject of urologic investigation.

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The Malone Antegrade Continence Enema: Single Institutional Review

Cited by 70 publications

References 20 publications

Continent catheterizable conduits in pediatric urology: One-center experience

Continent catheterizable conduits in pediatric urology: One-center experience

Peristeen anal irrigation as a substitute for the MACE procedure in children who are in need of reconstructive bladder surgery

Urologic management of spina bifida

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