Functional Outcome of Anorectal Malformations in a Tertiary Care Hospital in Bangladesh

Abstract

Background: The survival of anorectal malformation (ARM) patients has increased in the last ten years due to advances in newborn care and surgical methods for ARM patients. As a result, the current therapy of ARM patients is centred on functional results following definitive surgery. Aim of the study: The purpose of this study was to determine the type of ARM and measure functional outcomes, such as voluntary bowel movement (VBM), soiling, and constipation, in our patients following final surgery using the Krickenbeck classification. Methods: The current study is a cross-sectional study to retrospectively review medical records of ARM patients who underwent a definitive surgery at TMSS Medical College, Bogura, Bangladesh from 01 January 2022 to 31 December 2022 in which 45 cases were included. All collected data was entered into a Microsoft Excel Work Sheet and analyzed in SPSS 11.5 using descriptive statistics. Results: A total of 40 paediatric patients underwent hypospadias surgery. Of these, 38 (95%) cases were investigated. Most common type of hypospadias was coronal type (26.3%). Most of our patients did not have any associated urogenital problem (63.2%) and the most common associated anomaly was microphallus (7.9%). Most common surgical techniques was tabularized incised plate (65.8%). Most of our patients did not have any postoperative complications (52.6%) and most common complications was urethrocutanous fistula (31.6%). the presence of severe chordee (AOR=3.09; 95% CI 1.21-7.54; p=0.013) was significantly associated with postoperative problems. Conclusion: Functional outcomes of ARM patients in our institution are considered relatively favourable, with more than half of children showing VBM and just a small number of kids suffering from soiling and constipation. The frequency of VBM may be connected to birth weight and gender, but not ARM type, whereas soiling and constipation did not appear to be related to birth weight, gender, or ARM type. .......