Dataset Information

Transanal irrigation bowel routine for people with Cauda Equina Syndrome.

ABSTRACT:

Objective

Neurologic bowel incontinence and dysfunction are common with Cauda Equina Syndrome (CES). The study objective was to evaluate the efficacy of Peristeen Anal Irrigation System (PAIS)^TM in people with CES.

Design

Clinical Trial.

Setting

Spinal Cord Rehabilitation outpatient clinic at the Health Sciences Centre in Winnipeg.

Methods

Twelve participants with a mean age of 46.2 years (range 34-72 years, 4 females) with CES used PAIS^TM bowel routine for 10 weeks.

Outcome measures

Change in Neurogenic Bowel Dysfunction Score (NBD) over 10 weeks relative to baseline. Secondary outcomes: Change in St. Mark's Fecal Incontinence score (SMFI), Cleveland Clinic Constipation score (CCC), and modified Rectal Surgeons Fecal Incontinence Quality of Life Score (QOL) at week 1, 2, 4, 6, 8 and 10 compared to baseline, and self-rating of bowel function at baseline and 10 weeks. Additionally, colonic transit times were assessed using the radioactive markers (Sitzmarks) method.

Results

Ten participants completed the study. Post-intervention primary outcome NBD score improved (p < 0.01). Secondary outcomes also improved significantly, including SMFI (p < 0.01), CCC (p < 0.01), QOL (p < 0.01), self-rating of bowel function (p < 0.01), and transit time improved by 22% (p < 0.05).

Conclusion

Overall, a significant improvement was observed with the PAIS^TM for both primary, as well as secondary outcome measures, without any significant adverse effects. As this non-pharmaceutical method of bowel management is effective and has the potential to improve symptoms of bowel dysfunction in people with CES, it should be considered for those in which traditional methods of managing neurogenic bowel fail.

SUBMITTER: Ethans K

PROVIDER: S-EPMC10885772 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Publications

Transanal irrigation bowel routine for people with Cauda Equina Syndrome.

Ethans Karen K Smith Karen K Khandelwal Avni A Nankar Mayur M Shea Jessie J Casey Alan A

The journal of spinal cord medicine 20220202 2

<h4>Objective</h4>Neurologic bowel incontinence and dysfunction are common with Cauda Equina Syndrome (CES). The study objective was to evaluate the efficacy of Peristeen Anal Irrigation System (PAIS)<sup>TM</sup> in people with CES.<h4>Design</h4>Clinical Trial.<h4>Setting</h4>Spinal Cord Rehabilitation outpatient clinic at the Health Sciences Centre in Winnipeg.<h4>Methods</h4>Twelve participants with a mean age of 46.2 years (range 34-72 years, 4 females) with CES used PAIS<sup>TM</sup> bowel ...[more]

PMID: 35108169

Similar Datasets

Project description:IntroductionCauda Equina Syndrome (CES) can cause persisting life-changing dysfunction. There is scarce literature regarding the long-term assessment of CES symptoms, and rarer still is the impact of these symptoms on mental wellbeing investigated. This study assessed the long-term patient reported mental wellbeing outcomes of post-operative CES patients.MethodsPatients who underwent surgery for CES between August 2013 and November 2014 were identified using an ethically approved database. They then completed validated questionnaires over the telephone assessing their mental and physical functioning (Short-Form 12 Questionnaire), generating the Physical Component Summary (PCS) and Mental Component Summary (MCS). Bladder, bowel and sexual function were also assessed using validated questionnaires. MCS scores were compared to both the Scottish mean and previously published cut-offs indicating patients at risk of depression. Correlations of MCS with bladder, bowel, sexual and physical dysfunction were examined and multifactorial regression to predict MCS from these variables analysed. Independent t-tests assessed the mean difference in MCS between patients presenting with incomplete CES (CES-I) and CES with retention (CES-R) and between those with radiologically confirmed and impending CES.ResultsForty-six participants with a mean follow-up time of 43 months completed the study. The mean (±SD) MCS was 49 (±11.8) with 22% demonstrating poor mental health related quality of life in comparison to the Scottish mean. Overall, 37% had scores consistent with being at risk for depression with in the last 30 days, and 45% within the last 12 months. MCS was significantly correlated with Urinary Symptoms Profile (USP) score (-0.608), NBDS score (-0.556), ASEX score (-0.349) and PCS score (0.413) with worse bladder, bowel, sexual and physical dysfunction associated with worse MCS score. Multifactorial regression analysis demonstrated both urinary (USP score p = 0.031) and bowel function (NBDS score p = 0.009) to be significant predictive variables of mental health related quality of life. There were no significant mean differences in MCS between those presenting with CES-I and CES-R or those with radiologically complete and impending CES.DiscussionThis study demonstrates a high frequency of being at risk for depression in patients with CES and identifies outcome measures (physical, sexual and more so bladder and bowel dysfunction) associated with poorer mental wellbeing. Our large cohort and long follow-up highlight that CES patients should be considered at risk of depression, and the need to consider mental health outcomes following CES surgery.

Dataset Information

Transanal irrigation bowel routine for people with Cauda Equina Syndrome.

Objective

Design

Setting

Methods

Outcome measures

Results

Conclusion

Publications

Transanal irrigation bowel routine for people with Cauda Equina Syndrome.

Similar Datasets

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