THE MALONE ANTEGRADE CONTINENCE ENEMA FOR NEUROGENIC AND STRUCTURAL FECAL INCONTINENCE AND CONSTIPATION

Problems of fecal elimination are commonly encountered by the pediatri c urologist and surgeon. The Malone antegrade continence enema has bee n described as a means to administer a large volume enema via a contin ent catheterizable appendicocecostomy, resulting in reliable fecal eli mination. Of 22 patients undergoing this procedure 16 reported total c ontinence 4 months or longer after surgery. Complications are relative ly minor and tap water appears to be a safe solution for the antegrade continence enema. A nonrefluxing, imbricated appendicocecostomy is pr eferable to prevent cutaneous fecal or gas leaks.