Prevalence of Active Long-term Problems in Patients with Anorectal Malformations: A Systematic Review

Laurie Rigueros Springford, Martin J. Connor, Katie Jones, Venediktos V. Kapetanakis, Stefano Giuliani*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

72 Citations (Scopus)

Abstract

BACKGROUND: Anorectal malformations are a spectrum of congenital anomalies of the rectum with high infantile survival rates and variable outcomes. Long-term (>10 years old) active problems associated with this condition have been poorly investigated. OBJECTIVE: The purpose of this review was to systematically define the prevalence of the most common active long-term problems in patients with a history of anorectal malformation repair. DATA SOURCES: MEDLINE, EMBASE, and the Cochrane Library were searched electronically using the OVID search platform. STUDY SELECTION: Original articles from August 1, 1994, to October 20, 2015, that included outcome data for patients aged ≥10 years with anorectal malformation. Cloaca was excluded from the study. INTERVENTIONS: Prevalence estimates of anorectal malformations were obtained from published articles. CIs were ascertained in the logit scale after transforming prevalence into log odds and were then transformed into the original scale. The same method was used for subgroup analysis investigating high and low anorectal malformations. MAIN OUTCOME MEASURES: The overall prevalences of fecal, urinary, and sexual dysfunction were analyzed. RESULTS: Twelve studies including 455 patients with a history of anorectal malformation repair were included for analysis. The range of reported prevalence of long-term active problems was as follows: fecal incontinence, 16.7% to 76.7%; chronic constipation, 22.2% to 86.7%; urinary incontinence, 1.7% to 30.5%; ejaculatory dysfunction, 15.6% to 41.2%; and erectile dysfunction, 5.6% to 11.8%. LIMITATIONS: The study was limited by its retrospective, small size; multiple complex associated anomalies often not reported; and heterogeneous composition of patients with limited stratification analysis. CONCLUSIONS: There is an overall high prevalence of active long-term issues in adolescents and young adults with anorectal malformations. Additional multicenter research is needed to define characteristics and predictors of long-term outcome, to implement effective follow-up, and to transition to adult health care.

Original languageEnglish
Pages (from-to)570-580
Number of pages11
JournalDiseases of the Colon and Rectum
Volume59
Issue number6
DOIs
Publication statusPublished - 1 Jun 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The ASCRS 2016.

Keywords

  • Adult
  • Anorectal malformation
  • Constipation
  • Erectile dysfunction
  • Fecal incontinence
  • Follow-up
  • Imperforate anus
  • Neurogenic bladder
  • Outcomes
  • Prevalence
  • Urinary incontinence

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