eprintid: 10120696
rev_number: 14
eprint_status: archive
userid: 608
dir: disk0/10/12/06/96
datestamp: 2021-02-06 14:26:47
lastmod: 2021-10-19 21:54:47
status_changed: 2021-02-06 14:26:47
type: article
metadata_visibility: show
creators_name: Emmanuel, A
creators_name: Kurze, I
creators_name: Krogh, K
creators_name: Ferreiro Velasco, ME
creators_name: Christensen, P
creators_name: Del Popolo, G
creators_name: Bazzocchi, G
creators_name: Hultling, C
creators_name: Perrouin Verbe, B
creators_name: Bothig, R
creators_name: Glott, T
creators_name: Gonzalez Viejo, MA
title: An open prospective study on the efficacy of Navina Smart, an electronic system for transanal irrigation, in neurogenic bowel dysfunction
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G91
note: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. http://creativecommons.org/licenses/by/4.0/
abstract: Background:
Transanal irrigation (TAI) has emerged as a key option when more conservative bowel management does not help spinal cord injured (SCI) individuals with neurogenic bowel dysfunction (NBD).

Aim:
To investigate the short-term efficacy and safety of an electronic TAI system (Navina Smart) in subjects with NBD.

Design:
We present an open, prospective efficacy study on Navina Smart, in individuals with NBD secondary to SCI, studied at three months.

Population:
Eighty-nine consecutive consenting established SCI individuals (61 male; mean age 48, range 18–77) naïve to TAI treatment were recruited from ten centres in seven countries. Subjects had confirmed NBD of at least moderate severity (NBD score ≥10).

Methods:
Subjects were taught how to use the device at baseline assisted by the Navina Smart app, and treatment was tailored during phone calls until optimal TAI regime was achieved. The NBD score was measured at baseline and at three months follow up (mean 98 days). Safety analysis was performed on the complete population while per protocol (PP) analysis was performed on 52 subjects.

Results:
PP analysis showed a significant decrease in mean NBD score (17.8 to 10, p<0.00001). In subjects with severe symptoms (defined as NBD score ≥14), mean NBD scores decreased (19.4 to 10.9, p<0.0001). The number of subjects with severe symptoms decreased from 41 (79%) subjects at baseline to 16 (31%) at three months follow-up. Device failure accounted for the commonest cause for loss of data. Side effects possibly related to the device developed in 11 subjects (12%). Discontinuation due to failure of therapy to relieve symptoms was reported by 5 subjects (6%).

Conclusion:
Navina Smart is effective for individuals with NBD, even those with severe symptoms; long-term data will follow. Whilst there were some device problems (addressed by the later stages of subject recruitment) the treatment was generally safe.
date: 2021-01-29
date_type: published
official_url: https://doi.org/10.1371/journal.pone.0245453
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1844764
doi: 10.1371/journal.pone.0245453
pii: PONE-D-19-33572
lyricists_name: Emmanuel, Anton
lyricists_id: AVEMM74
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: PLoS One
volume: 16
number: 1
article_number: e0245453
event_location: United States
citation:        Emmanuel, A;    Kurze, I;    Krogh, K;    Ferreiro Velasco, ME;    Christensen, P;    Del Popolo, G;    Bazzocchi, G;                     ... Gonzalez Viejo, MA; + view all <#>        Emmanuel, A;  Kurze, I;  Krogh, K;  Ferreiro Velasco, ME;  Christensen, P;  Del Popolo, G;  Bazzocchi, G;  Hultling, C;  Perrouin Verbe, B;  Bothig, R;  Glott, T;  Gonzalez Viejo, MA;   - view fewer <#>    (2021)    An open prospective study on the efficacy of Navina Smart, an electronic system for transanal irrigation, in neurogenic bowel dysfunction.                   PLoS One , 16  (1)    , Article e0245453.  10.1371/journal.pone.0245453 <https://doi.org/10.1371/journal.pone.0245453>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10120696/1/journal.pone.0245453.pdf