ABSTRACT
A 9-year-old patient comes to your clinic for his initial visit with a history of myelomeningocele, neurogenic bowel, and neurogenic bladder. The patient's past surgical history includes myelomeningocele closure. At another institution, to manage frequent impaction, a sigmoid resection and Malone appendicostomy were performed, and to manage urinary incontinence a colovesicostomy was done. The patient is currently doing a daily Malone flush which consists of 200 mL of saline and 10 mL of glycerin. His parents report that the flush infuses over 10 minutes and that the patient typically sits for 60 minutes. They also report good output with the flush but with fecal soiling one to two times a day. She is dry, emptying her urinary stoma several times a day.
