Peristeen(®) transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study

Aim In paediatric and adults patients with neurogenic bowel (NB), TransAnal Irrigation (TAI) of the colon has gained popularity due to the introduction of a specifically designed device. The aim of this pilot study was to present the results of TAI using Peristeen® Trans Anal Irrigation (PTAI) in a group of paediatric patients with anorectal malformations (ARM) and congenital or acquired spinal cord lesions (SCL). Method Eight Italian paediatric surgery and spina bifida centres participated in the study. The inclusion criteria were age between 6-17 years, weight above 20 kg, and unsatisfactory bowel management. Patients with chronic inflammatory bowel disease, mental disability and surgery within the previous three months were excluded. At the beginning of treatment (T0) and after three months (T1), the Bristol scale, a questionnaire assessing bowel function and two questionnaires on quality of life for patients aged 6-11 years (CHQ pf50) and 12-17 years (SF36) were administered. Results Eighty-three patients were enrolled, and seventy-eight completed the study (41 ARM, 37 SCL). At T1, constipation was reduced in ARM from 69% to 25,6% and in SCL from 92,7% to 41,5%, faecal incontinence in ARM from 50% to 18.6%, and in SCL from 39% to 9.8% and flatus incontinence in ARM from 20.9% to 9,8%, and in SCL from 31.7% to 10%. At T0, the Bristol Stool Scale types were 1-2 in 45% of ARM and 77.5% of SCL patients, whereas at T1 types 1-2 were recorded in only 2,5% of SCL patients. Quality of life (QoL) improved in both groups. In the younger group, a significant improvement in QoL was recorded in ARM patients for 8 of 9 variables and in SCL patients for 7 of 9 variables. Conclusion This study showed that PTAI resulted in a significant time reduction in colonic cleansing, increased independence from the carer, and improved QoL in paediatric patients with ARM and SCL.