Malone Antegrade Continence Enema (MACE)

Mr. RB is still having significant bowel issues. Before recommending colostomy, the pros and cons of the Malone Antegrade Continence Enema are discussed by the general surgeon with his team.
Q13.  What is a Malone Antegrade Continence Enema?
1. MACE is an approach used to create an entry into the large intestine for irrigation.
2. MACE is a safe and effective treatment for severe, chronic gastrointestinal problems in persons with SCI where conservative bowel management options are unsuccessful.


Figure 9.The MACE procedure provides a catheterizable channel through which antegrade colonic washout can be performed. Reprinted with permission from Malone PSJ. Malone procedure for antegrade continence enemas. In: Spitz L, and Coran AG, eds. Rob & Smith’s Operative Surgery: Pediatric Surgery. 5th ed. London: Chapman & Hall Medical; 1995:459–467.