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Anorectal malformations: what happens in adulthood?
Melissa C Davies1, Lih-Mei Liao, Duncan T Wilcox
1UCL Institute of Women's Health, University College London Hospitals, London, UK.
BJU International
|November 6, 2009
Summary
Adults with anorectal malformations (ARMs) experience significant urinary and bowel incontinence, negatively impacting their sexual well-being and quality of life. Transition care must address these long-term outcomes.
Area of Science:
- Urology
- Gastroenterology
- Sexual Health
Background:
- Advances in surgical treatment have increased survival rates for individuals with anorectal malformations (ARMs).
- Adult data on urinary and bowel function in ARM survivors are limited.
- The impact of ARM diagnosis and treatment on sexual and reproductive function in adults is poorly understood.
Purpose of the Study:
- To evaluate long-term outcomes in adults born with ARMs.
- To correlate ARM types with functional outcomes.
- To examine the relationship between bowel/urinary function and sexual well-being.
Main Methods:
- Seventy-four adult patients with confirmed ARM diagnoses participated.
- Validated questionnaires assessed urinary function, bowel function, body esteem, sexual well-being, fertility, and quality of life.
- Data were compared to control groups where applicable.
Main Results:
- High rates of urinary and bowel incontinence were reported by both men and women.
- Higher ARM severity correlated with increased incontinence.
- Adult ARM survivors reported poorer body esteem, sexual well-being, and quality of life compared to controls.
- Urinary and bowel incontinence were linked to diminished sexual well-being.
Conclusions:
- Adult outcomes for bowel and urinary function in ARM survivors are worse than previously reported.
- Incontinence significantly affects sexual well-being and overall quality of life.
- Multidisciplinary care during the transition from pediatric to adult healthcare is crucial to address these issues, particularly sexual health concerns.
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