The Malone antegrade continence enema procedure

Quality of life and family perspective

Elizabeth B. Yerkes, Mark P. Cain, Shelly King, Timothy Brei, Martin Kaefer, Anthony J. Casale, Richard C. Rink

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Purpose: Since introducing the Malone antegrade continence enema (MACE) procedure into our practice, it has been our bias that social confidence and independence are significantly improved and satisfaction is overwhelmingly high. We objectively determine outcomes after the MACE to refine patient selection, and maximize the quality of perioperative counseling and teaching. Materials and Methods: An anonymous questionnaire was mailed to all patients who had undergone the MACE procedure within the last 4 years. Patient/parent satisfaction, impact on quality of life and clinical outcome were assessed with Likert scales. Demographic information, MACE specifics, preoperative expectations, and unanticipated benefits and problems were also recorded. Results: A total of 65 questionnaires were returned from our first 92 patients (71%). Myelodysplasia was the primary diagnosis in 88% of patients. Complete or near complete fecal continence was achieved in 77% of patients and all others had improved incontinence. The highest level of satisfaction was reported by 89% of patients. Social confidence and hygiene were significantly improved. Daily time commitment, pain/cramping, intermittent constipation and time for fine-tuning the regimen were cited as unanticipated issues. Conclusions: The MACE procedure has received high praise from patients and families after years of battling constipation and fecal incontinence. Significant improvement rather than perfection is the realistic expectation. Objective feedback from patients and families will continue to improve patient selection and education.

Original languageEnglish (US)
Pages (from-to)320-323
Number of pages4
JournalJournal of Urology
Volume169
Issue number1
StatePublished - Jan 1 2003
Externally publishedYes

Fingerprint

Enema
Quality of Life
Constipation
Patient Selection
Fecal Incontinence
Patient Education
Hygiene
Patient Satisfaction
Counseling
Teaching
Demography
Pain

Keywords

  • Enema
  • Fecal incontinence
  • Personal satisfaction
  • Quality of life

ASJC Scopus subject areas

  • Urology

Cite this

Yerkes, E. B., Cain, M. P., King, S., Brei, T., Kaefer, M., Casale, A. J., & Rink, R. C. (2003). The Malone antegrade continence enema procedure: Quality of life and family perspective. Journal of Urology, 169(1), 320-323.

The Malone antegrade continence enema procedure : Quality of life and family perspective. / Yerkes, Elizabeth B.; Cain, Mark P.; King, Shelly; Brei, Timothy; Kaefer, Martin; Casale, Anthony J.; Rink, Richard C.

In: Journal of Urology, Vol. 169, No. 1, 01.01.2003, p. 320-323.

Research output: Contribution to journalArticle

Yerkes, EB, Cain, MP, King, S, Brei, T, Kaefer, M, Casale, AJ & Rink, RC 2003, 'The Malone antegrade continence enema procedure: Quality of life and family perspective', Journal of Urology, vol. 169, no. 1, pp. 320-323.
Yerkes EB, Cain MP, King S, Brei T, Kaefer M, Casale AJ et al. The Malone antegrade continence enema procedure: Quality of life and family perspective. Journal of Urology. 2003 Jan 1;169(1):320-323.
Yerkes, Elizabeth B. ; Cain, Mark P. ; King, Shelly ; Brei, Timothy ; Kaefer, Martin ; Casale, Anthony J. ; Rink, Richard C. / The Malone antegrade continence enema procedure : Quality of life and family perspective. In: Journal of Urology. 2003 ; Vol. 169, No. 1. pp. 320-323.
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