van Straveren RJ, Langemijer RA, Molenaar JC; International Society of Technology Assessment in Health Care. Meeting.
Abstr Int Soc Technol Assess Health Care Meet. 1993; 9: 226.
Department of Paediatric Surgery, Sophia Children's Hospital, Rotterdam, The Netherlands.
BACKGROUND. Children who undergo a Posterior Sagittal Anorectoplasty (PSARP) to correct congenital anorectal malformations, will not achieve normal continence of faeces. This causes many problems in physical, psychological, developmental and social well-being, both in childhood and beyond. Anorectal manometry might be of value in helping these youngsters to deal with their incontinence problems. METHODS. Forty-nine patients, who underwent a PSARP between 1983 and 1990, were followed. Incontinence was defined as faecal soiling at least once a day. Subjective methods (interviews and questionnaires) and objective methods (anorectal manometry) were used to evaluate the severity of the incontinence and the related problems. Children having reached the age of 5 were offered a treatment scheme based on the subjective and objective evaluations. RESULTS. All patients were shown to be incontinent after objective evaluation. However, from the interviews and questionnaires it appeared that not all children considered themselves incontinent. Twenty-four children who reached the age of 5 were offered a treatment scheme. Treatment depended on the severity of the incontinence and related problems, and ranged from diets combined with defaecation regimen to different types of enema regimens. Twenty patients learned to deal with their incontinence and were able to function normally. CONCLUSIONS. The use of anorectal manometry as an objective method for evaluating faecal incontinence problems greatly improves the possibilities for an effective and efficient treatment of faecal incontinence problems. Anorectal manometry requires a specific infrastructure, skills and expertise. It is therefore best performed in specialized centres. A cost-effectiveness study is being carried out.
Publication Types:
Keywords:
- Anal Canal
- Anus Diseases
- Autonomic Nervous System Diseases
- Child
- Colostomy
- Defecation
- Digestive System Surgical Procedures
- Fecal Incontinence
- Humans
- Questionnaires
- Reconstructive Surgical Procedures
- Reoperation
- Urinary Incontinence
- methods
- surgery
- therapy
- hsrmtgs
Other ID:
UI: 102211606
From Meeting Abstracts