The antegrade continence enema procedure why, when and how?

Following the description of the antegrade continence enema (ACE) 7 years ago, it has become widely performed and accepted as the most successful treatment for intractable faecal incontinence. Modifications of the operative technique and enema regimen have been described, but the basic principle remains. This paper traces the evolution of the ACE and describes criteria for patient selection, operative technique and enema regimens.