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. 2024 Apr 3;40(1):95.
doi: 10.1007/s00383-024-05684-2.

Assessment of long-term quality of life, bowel and voiding function outcomes in patients with anorectal malformation at a single UK centre

Harriet Beattie  1   2 , Thejasvi Subramanian  1 , Elizabeth Scudamore  1 , Thomas Middleton  1 , Caroline MacDonald  1 , Richard Lindley  1 , Govind Murthi  3
Affiliations

Assessment of long-term quality of life, bowel and voiding function outcomes in patients with anorectal malformation at a single UK centre

Harriet Beattie et al. Pediatr Surg Int. .

Abstract

Aims: Assess long-term quality of life (QoL), bowel and voiding function in anorectal malformation (ARM) paediatric patients.

Method: Retrospective review of ARM patients between 2007 and 2020 was performed. QoL (all patients), bowel and voiding function (> 5 yo) were assessed using the paediatric quality of life inventory (PedsQL), paediatric incontinence and constipation score (PICS) and dysfunctional voiding scoring system (DVSS), respectively.

Results: There were 122 patients (49% female, 85 > 5 yo) with ARM. Two had died, four refused, twenty-two were non-contactable, leaving ninety-four patients (65 > 5 yo) included. Mean age was 89 months (19-183), and follow-up was 86 months (13-183). Patients had significantly poorer scores for QoL, bowel and voiding function compared to published healthy controls. 57% had poor bowel function, 32% had poor voiding function and 38% required 'ancillary aids' to facilitate function. Patients using 'ancillary aids' for voiding function had a significantly lower QoL (parent: 62 vs 77; p = 0.01, patient: 66 vs 79; p = 0.05). Bowel continence was worse in those with high vs low ARM (13 vs 20, p = 0.004) and timely vs delayed diagnosis (17 vs 24, p = 0.04).

Conclusion: Patients with ARM have significantly worse QoL, bowel and voiding function than normal healthy controls. There is a need for long-term monitoring of function and further support for these children.

Level of evidence: III.

Keywords: Anorectal malformation; Bowel function; Children; Outcomes; Paediatric; Quality of life; Urinary function.

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