FI: nm - better rectal 30min/d, 5 d/w (improvement of any Constipation: sensation parameter) nm - ability to 71% complete bowel continence hold No adverse effects consciously Han et al, 04 n= 24 SB FU: 15.8 No stool loss Single centre Mean episodes of faecal Not evaluated 25 Age: 4-13y months Retrospective case review incontinence decreased LL: nm TT: nm Daily 1h at home transurethral significant from 7.3 to 4.8 a FI: nm ES, 5days/w for 4w week (p<0.05) Constipation: FU cycles: 2w every 3 to 6mo Complete faecal continence in nm One week diary before 50% (12/24) treatment and subsequent Urinary tract infections in 10 cycles patients during transurethral ES Kajbafzadeh n= 30 SB FU: nm Stool loss < Single centre Constipation is decreased in Not evaluated et al, 12 26 Age: 3-12y TT: nm 1x/ week Randomized controlled trial 11/15 (73%) and remained in LL: nm Home cutaneous ES for 20 min, 8/15 (53%) after 6mo FI: nm 3x/w: 15 treatment, 15 sham Significant increase of stool Constipation: Bowel habit diary, NBD: range frequency from 2.5 to 4.7 nm (47= severe bowel stools/w after treatment dysfunction)45 Significant improvement Manometry before and 6mo manometry measures after treatment No adverse effects Legend: ES: electrical stimulation, SB: spina bifida, FU: follow up, NBD: neurogenic bowel dysfunction Table 3: Summary of papers on non conservative bowel management in spina bifida patients Author Sample Follow up/ Definition Study design Findings - effectiveness Findings - satisfaction defecation faecal Findings - complications time continence Hensle et al, N= 27 SB FU: 9-30 Not defined Single centre 2 dropped out 25/27 reported substantial 97 27 Age: 10-31y months Retrospective case review 19/25 (76%): complete bowel improvement in their QoL 22 wheelchair TT: 30 min Malone ACE, 8 concomitant control
FI: nm Constipation: nm - better rectal sensation - ability to hold consciously 30min/d, 5 d/w (improvement of any parameter) 71% complete bowel continence No adverse effects Han et al, 04 25 n= 24 SB Age: 4-13y LL: nm FI: nm Constipation: nm FU: 15.8 months TT: nm No stool loss Single centre Retrospective case review Daily 1h at home transurethral ES, 5days/w for 4w FU cycles: 2w every 3 to 6mo One week diary before treatment and subsequent cycles Mean episodes of faecal incontinence decreased significant from 7.3 to 4.8 a week (p<0.05) Complete faecal continence in 50% (12/24) Urinary tract infections in 10 patients during transurethral ES Not evaluated Kajbafzadeh et al, 12 26 n= 30 SB Age: 3-12y LL: nm FI: nm Constipation: nm FU: nm TT: nm Stool loss < 1x/ week Single centre Randomized controlled trial Home cutaneous ES for 20 min, 3x/w: 15 treatment, 15 sham Bowel habit diary, NBD: range (47= severe bowel dysfunction)45 Manometry before and 6mo after treatment Constipation is decreased in 11/15 (73%) and remained in 8/15 (53%) after 6mo Significant increase of stool frequency from 2.5 to 4.7 stools/w after treatment Significant improvement manometry measures No adverse effects Not evaluated Legend: ES: electrical stimulation, SB: spina bifida, FU: follow up, NBD: neurogenic bowel dysfunction Table 3: Summary of papers on non conservative bowel management in spina bifida patients Author Sample Follow up/ defecation time Definition faecal continence Study design Findings - effectiveness Findings - complications Findings - satisfaction Hensle et al, 97 27 N= 27 SB Age: 10-31y 22 wheelchair FU: 9-30 months TT: 30 min Not defined Single centre Retrospective case review Malone ACE, 8 concomitant 2 dropped out 19/25 (76%): complete bowel control 25/27 reported substantial improvement in their QoL
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