Sexual function and fertility of adult males with anorectal malformations or Hirschsprung disease

• Published in: Pediatric surgery international 2022-12, Vol.38 (12), p.1693-1699
• 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: Erectile dysfunction; Fertility; Medicine; Medicine & Public Health; Original Article; Pediatric Surgery; Pediatrics; Surgery
• ISSN: 1437-9813; 0179-0358; 1437-9813
• DOI: 10.1007/s00383-022-05216-w

Purpose The long-term impact of anorectal malformations (ARM) and Hirschsprung disease (HD) on sexual function is well recognized but understudied. This study evaluated self-reported sexual and fertility outcomes in adult males with ARM and HD. Methods This was an IRB approved, prospective study of males in the Adult Colorectal Research Registry who completed surveys between October 2019 and March 2022. Electronic surveys were administered after consenting to being contacted for research. Patients completed the International Index of Erectile Function (IIEF) questionnaire and provided information on fertility outcomes. Results Sixty-five patients completed outcome questionnaires: 11 (16.9%) had HD and 54 (83.1%) had an ARM. Nineteen patients reported some degree of erectile dysfunction per IIEF criteria, a greater proportion of whom have ARM ( p  = 0.046). Twenty (30.7%) have reported having children; there were no differences in rates between HD and ARM patients. Most patients had not attempted to conceive, but eight patients, all of whom have ARM, have pursued fertility investigation or treatments. Conclusion More patients with ARM reported some degree of erectile dysfunction compared to those with HD. Additionally, some have required fertility treatments. Further investigation is warranted to ensure true low rates of sexual and fertility dysfunction in patients with HD.