Fertility and Sexual Function in Males with Hirschsprung's Disease: A Nordic Cross-Sectional Study

Abstract

Objective: The aim was to assess fertility, sexual function and sexual quality of life in males with Hirschsprung's disease (HSCR) in the Nordic countries with a cross-sectional study using self-reported validated questionnaires.

Summary background data: Data on fertility and sexual function in males with HSCR are limited.

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

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

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