Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations-A Systematic Review

Area of Science:

• Pediatric Surgery
• Urology
• Reproductive Medicine

Background:

• Long-term outcomes of anorectal malformations (ARM) repair are influenced by associated anomalies and surgical techniques.
• The precise prevalence of long-term urinary and sexual dysfunction following ARM repair remains insufficiently understood.

Purpose of the Study:

• To determine the prevalence of urinary and sexual dysfunction in patients over 10 years old who underwent ARM repair in infancy.

Main Methods:

• A systematic literature review was conducted across Medline, Embase, and Cochrane databases.
• Included studies reported on urinary incontinence (UI), lower urinary tract symptoms (LUTS), neurogenic bladder dysfunction (NBD), sexual dysfunction (SD), erectile dysfunction (ED), ejaculatory dysfunction, and birth rate.
• Seventeen studies were synthesized from an initial pool of 588 identified articles.

Main Results:

• Combined prevalence estimates included: UI 16%, LUTS/NBD 36%, SD in women 50%, ED 12%, ejaculatory dysfunction 16%, and birth rate 20%.
• Higher ARM severity correlated with increased prevalence of ED and ejaculatory dysfunction.
• Urinary incontinence and sexual dysfunctions were found to be common in both males and females post-ARM repair.

Conclusions:

• Patients who undergo ARM repair experience a high prevalence of long-term UI, ED, and SD.
• There is a critical need for larger, multicenter trials with standardized populations to optimize treatment and follow-up strategies.