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Incontinence and constipation after low anorectal malformations in a boy.
S Labouré1, R Besson, M D Lamblin
1Department of Paediatric Surgery, Jeanne de Flandres Hospital, University of Lille, France.
Summary
Low anorectal malformations can lead to long-term continence issues in children. Regular clinical follow-up and anorectal manometry are recommended for early detection and management of these problems.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Urology
Background:
- Low anorectal malformations (LAM) are typically considered benign congenital anomalies.
- Neonatal surgical treatment of LAM generally yields good functional outcomes regarding continence.
Observation:
- A cohort of 55 boys with LAM treated between 1975-1992 was retrospectively studied.
- Long-term follow-up (3-20 years post-operation) included clinical interviews and examinations for 27 patients.
- Anorectal manometry was performed on consenting patients with persistent issues.
Findings:
- Nearly half of the patients (48%) experienced soiling or chronic constipation despite initial successful continence acquisition.
- Anorectal manometry revealed anorectal dyssynergies in 4 out of 9 evaluated patients.
- No significant differences were noted in malformation type, initial treatment, or follow-up between continent and incontinent groups.
Implications:
- Continence problems are not uncommon in the long-term management of low anorectal malformations.
- Routine, long-term clinical surveillance is advised for all children with LAM.
- Post-continence anorectal manometry may aid in identifying underlying functional abnormalities.