Fertility and Sexual Function in Males With Hirschsprung Disease: A Nordic Cross-sectional Study

To assess fertility, sexual function, and sexual quality of life in males with Hirschsprung disease (HSCR) in the Nordic countries with a cross-sectional study using self-reported validated questionnaires.

Data on fertility and sexual function in males with HSCR are limited.

This multicenter study targeted all males born between 1970 and 2003 who underwent pull-through surgery at a pediatric surgery center in Sweden, Denmark, Norway, or Finland. Participants completed a multidomain questionnaire. Demographic data were collected retrospectively from the medical records. Patients with trisomy 21 and other syndromes associated with intellectual disability were excluded. The main outcomes were fertility, sexual function, and sexual quality of life.

A total of 169 patients (median age: 32 years) were included. Of 63 individuals attempting to father a biological child, 8 (12.7%) reported failure to conceive after 1 year, and 5 (7.9%) reported failure to conceive after 2 years. Our cohort did not report impaired fertility, a higher prevalence of erectile dysfunction, or lower sexual quality of life scores compared with normative summary data. Poor bowel function was associated with impaired fertility and erectile dysfunction ( P = 0.0278 and P = 0.0026, respectively). The length of the aganglionic segment and surgical method did not seem to affect fertility, sexual function, or sexual quality of life.

Males with HSCR who have undergone pull-through surgery do not seem to report overall reduced fertility, higher prevalence of erectile dysfunction, or reduced sexual quality of life compared with estimates from the general population. Impaired bowel function may correlate with erectile dysfunction and impaired fertility in affected individuals.