Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Feb 3:25:29-38.
doi: 10.1016/j.euros.2021.01.007. eCollection 2021 Mar.

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

Thomas Bjoersum-Meyer  1   2 , Lasse Kaalby  1   2 , Lars Lund  3 , Peter Christensen  4 , Marianne S Jakobsen  5 , Gunnar Baatrup  1   2 , Niels Qvist  1   2 , Mark Ellebaek  1   2
Affiliations
Review

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

Thomas Bjoersum-Meyer et al. Eur Urol Open Sci. .

Abstract

Context: Long-term urinary and sexual outcomes after repair of anorectal malformations (ARMs) are currently affected by concomitant malformations of the urinary tract and genitalia, sacral anomalies, and the surgical approach. However, the overall prevalence of urinary and sexual dysfunction remains unclear.

Objective: To evaluate the prevalence of urinary and sexual dysfunction in patients aged >10 yr after repair of ARM in infancy.

Evidence acquisition: A systematic literature review was performed using the Medline, Embase, and Cochrane databases. Selected studies were reviewed according to the Consolidated Standards of Reporting Trials (CONSORT) and Standards for the Reporting of Diagnostic Accuracy Studies (STARD) criteria. We included studies reporting the prevalence of the following outcomes: urinary incontinence (UI), lower urinary tract symptoms (LUTS), neurogenic bladder dysfunction (NBD), sexual dysfunction (SD), erectile dysfunction (ED), ejaculatory dysfunction, and birth rate. We initially identified 588 studies, of which 17 were included for evidence synthesis.

Evidence synthesis: A probabilistic meta-analysis on each subgroup revealed the following combined prevalence estimates: UI 16% (95% confidence interval [CI] 7-27%), LUTS/NBD 36% (95% CI 13-62%), SD among women 50% (95% CI 34-66%), ED 12% (95% CI 7-18%), ejaculatory dysfunction 16% (95% CI 9-25%), and birth rate 20% (95% CI 7-38%). Subgroup analysis showed a higher prevalence of ED and ejaculatory dysfunction among patients with high ARM severity when compared to low ARM severity.

Conclusions: Among patients undergoing ARM repair, we found a high prevalence of long-term impairment of UI, ED, and SD. We stress the need for larger multicentre trials with more comparable populations to optimise treatment and follow-up regimens.

Patient summary: We reviewed long-term outcomes for patients with anorectal malformations who underwent surgery and found that both urinary incontinence and sexual dysfunctions are common for both males and females.

Keywords: Anorectal malformation; Paediatric surgery; Sexual outcome; Urinary outcome.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the study selection process.
Fig. 2
Fig. 2
Forest plots of the reported prevalence of urinary incontinence, lower urinary tract symptoms (LUTS)/neurogenic bladder dysfunction (NBD), and birth rate for patients with anorectal malformations. ES = effect size; CI = confidence interval.
Fig. 3
Fig. 3
Forest plots of the reported prevalence of sexual dysfunction, erectile dysfunction, and ejaculatory dysfunction for patients with anorectal malformations. ES = effect size; CI = confidence interval.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Levitt M.A., Pena A. Anorectal malformations. Orphanet J Rare Dis. 2007;2:33. - PMC - PubMed
    1. Cuschieri A., EUROCAT Working Group Anorectal anomalies associated with or as part of other anomalies. Am J Med Genet. 2002;110:122–130. - PubMed
    1. Stoll C., Alembik Y., Dott B., Roth M.P. Associated malformations in patients with anorectal anomalies. Eur J Med Genet. 2007;50:281–290. - PubMed
    1. Pena A. Anorectal malformations. Semin Pediatr Surg. 1995;4:35–47. - PubMed
    1. Hassink E.A., Rieu P.N., Hamel B.C., Severijnen R.S., van der Staak F.H., Festen C. Additional congenital defects in anorectal malformations. Eur J Pediatr. 1996;155:477–482. - PubMed

LinkOut - more resources