1000 Section - High Bowel Irrigation System via Transrectal Lubricated Catheter and Specialized Water Delivery Device for the Management of Neurogenic Bowel

Neurogenic bowel dysfunction (NBD) is a common complication in patients with spinal cord injury (SCI), often requiring specialized bowel management strategies. High bowel irrigation via a transrectal lubricated catheter and a specialized water delivery device has been proposed as an effective intervention. To evaluate the effectiveness, safety, and patient compliance of a high bowel irrigation system in SCI patients with neurogenic bowel dysfunction over an 18-month period.

Design: Twenty-one inpatients (16 men, 5 women) from a rehabilitation center with SCI were included. 6/21 patients had incomplete tetraplegia.10/21 patients had high paraplegia, of whom 4/10 had incomplete lesions and 6/10 had complete lesions of the spinal cord.5/21 patients had cauda equina syndrome.
Assessments included motor function, trunk balance, spasticity, ability for self- or assisted irrigation, bowel evacuation effectiveness, procedure duration, compliance, and coexistence with neurogenic bladder

Results:

Five patients (23.8%) with high tetraplegia discontinued the method after 4–6 months due to the need for assisted catheterization. Sixteen patients (76.2%) continued to use the method for 8–18 months with consistent results. Significant improvement in bowel evacuation was noted, achieving complete emptying every other day. Use of a specialized trunk-support chair facilitated application in patients with poor balance. The method showed highest effectiveness in patients with cauda equina syndrome, while generalized spasticity of the lower limbs and external anal sphincter presented relative difficulty

Conclusion: High bowel irrigation via a transrectal lubricated catheter and specialized water delivery device appears to be a promising method for managing neurogenic bowel in SCI patients, improving evacuation efficiency and patient compliance