Bowel function, urinary tract function, and health-related quality of life in males with anorectal malformations
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In brief
In brief
This cross-sectional study of 58 male patients treated for anorectal malformations found that while bowel function was impaired compared to controls, it significantly improved with age. Urinary symptoms were slightly elevated but comparable to controls, and health-related quality of life remained unaffected.
- Only 42% of male ARM patients achieved well-preserved bowel function (BFS ≥17) vs 95% of controls, but function improves significantly with age.
- Soiling and urge sensation in ARM patients improve with age; bowel function score increases significantly in older patients.
- Male ARM patients report more straining and stress incontinence than controls, though overall urinary symptoms are comparable.
- Health-related quality of life in male ARM patients is similar to or better than normative data despite functional impairments.
- No significant association found between bowel function, urinary function, and quality of life outcomes in this male ARM cohort.
Written by the GCMD Library team from the article.
Abstract
Purpose
There is a knowledge gap regarding long-term outcomes for males undergoing surgery for an anorectal malformation (ARM). The purpose of this study was to investigate bowel function, bladder function, and health-related quality of life (HRQoL) in male patients with an anorectal malformation.
Methods
This cross-sectional questionnaire-based study included males treated for ARM at our institution between 1994 and 2017. Bowel function was assessed with bowel function score (BFS) while urinary tract function was assessed with lower urinary tract symptoms (LUTS) questionnaires. Health-related quality of life (HRQoL) was investigated using age-relevant questionnaires (KIDSCREEN and PGWBI). Patient characteristics were retrospectively collected from the medical records and descriptive statistics were used for analysis. Functional outcomes were compared with gender and age-matched controls while HRQoL was compared to normative data. The study was approved by ethics review authorities.
Results
A total of 58 (44.6%) of 130 males responded to the questionnaires. Regarding bowel function, 24 (42.1%) of 57 patients and 81 (95.3%) of 85 controls, respectively, reported a well-preserved bowel function represented by a BFS ≥ 17 (p < 0.001). Soiling issues and ‘feels urge’ items improved significantly with age. In a linear regression model, BFS increased significantly with age. For most parameters, the proportion of ARM patients with lower urinary tract symptoms was larger, though not significantly, compared to the controls. However, straining and stress incontinence were reported significantly more often by ARM patients. In patients and controls, voiding outcomes in terms of prevalence of having symptoms and the number of cumulative symptoms drop with increasing age. Children and adults reported similar or, in some domains, better HRQoL outcomes when compared to normative European data.
Conclusion
Bowel function is impaired in male patients with ARM but significantly improves with age. Urinary tract function was affected, but overall comparable to the controls. HRQoL was unaffected. No significant association between the studied outcomes could be shown.
Level of evidence
III.