Patient-reported urinary outcomes in adult males with congenital colorectal conditions

• Published in: Pediatric surgery international 2022-12, Vol.38 (12), p.1709-1716
• Main Authors: Reppucci, Marina L., Wehrli, Lea A., Wilcox, Duncan, Ketzer, Jill, Pena, Alberto, de la Torre, Luis, Bischoff, Andrea, Wood, Dan
• Format: Article
• Language: English
• Subjects: Adults; Males; Medicine; Medicine & Public Health; Original Article; Pediatric Surgery; Pediatrics; Surgery; Urinary incontinence
• ISSN: 1437-9813; 0179-0358; 1437-9813
• DOI: 10.1007/s00383-022-05215-x

Purpose Long-term urinary outcomes for patients born with Hirschsprung disease (HD) and anorectal malformations (ARM) may impact their health and wellbeing into adulthood. This study describes self-reported long-term urinary outcomes in males with HD and ARM. Methods This was a prospective study of male patients in the Adult Colorectal Research Registry who completed surveys on urinary function between October 2019 and March 2022. Self-reported health and functional outcomes were summarized, and differences based on type of condition were compared. Results Sixty-seven patients completed the questionnaire (response rate: 59.1%), of which 17.9% (12) had HD and 82.1% (55) had an ARM. Rates of urinary incontinence and stress urinary incontinence were 16.4% (11) and 4.5% (3), respectively. On sub-analysis of patients with ARM, patients with sacral ratio (SR) of 0.4–0.69 reported higher UTI rates compared to those with SR ≥ 0.7 (57.9 vs 25.8%, p  = 0.023). Renal failure rates were highest among patients with recto-bladder neck fistulas (66.0%, p  = 0.012). Conclusion Patients with HD and ARM report a variety of urological sequelae in adulthood. Outcomes appear to be more common in patients with ARM and may be impacted by both anatomy and sacral ratios. Transitional care to monitor and manage renal and urological function is imperative.