Impact of Spinal Defects on Urinary and Sexual Outcome in Adults With Anorectal Malformations—A Cross-sectional Study

Abstract

To examine the impact of spinal defects on urinary function, sexual outcome and quality of life in adult patients born with anorectal malformations. A prospective cohort study at Odense University Hospital in Denmark was conducted. From 1985 to 2000, 93 patients were found eligible for participation. Twenty-seven (29%) consented to participate. One patient refrained from clinical examinations. Patients were examined with magnetic resonance imaging, uroflowmetry, and validated questionnaires on urinary function, sexual function, and quality of life. There were 14 were females and 13 were males, median age of 25 (range 19-31) years and 23 (18-32) years, respectively. The type of anorectal malformations in females were vestibular fistula (n=6), anocutaneous fistula (n=4), anal stenosis (n=3), and cloaca (n=1). In males the type of malformations were anocutaneous fistula (n=4), bulbar fistula (n=4), rectovesical fistula (n=2), anal stenosis (n=1), rectal atresia (n=1), and anal atresia with no fistula (n=1). Patients with spinal defects had a lower average voiding rate compared to patients with normal spinal anatomy (P .03), a lower voiding-related quality of life (P .02), and a tendency was observed toward a worse total urinary incontinence-related quality of life score (P .06). Moreover in patients with spinal defect a tendency was seen toward a worse general quality of life (P .09). Spinal defects detected by magnetic resonance imaging in adults with anorectal malformations were found to be associated with urinary voiding function.