An open prospective study on the efficacy of Navina Smart, an electronic system for transanal irrigation, in neurogenic bowel dysfunction.

Abstract

BackgroundTransanal 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).AimTo investigate the short-term efficacy and safety of an electronic TAI system (Navina Smart) in subjects with NBD.DesignWe present an open, prospective efficacy study on Navina Smart, in individuals with NBD secondary to SCI, studied at three months.PopulationEighty-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).MethodsSubjects 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.ResultsPP analysis showed a significant decrease in mean NBD score (17.8 to 10, pConclusionNavina 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.Clinical trial(ClinicalTrials.gov number NCT02979808).