Lower urinary tract symptoms in children with anorectal malformations with rectoperineal fistulas

J Pediatr Surg. 2016 Aug;51(8):1234-40. doi: 10.1016/j.jpedsurg.2016.01.015. Epub 2016 Feb 4.

Abstract

Aim: The aim was to describe the frequency of lower urinary tract symptoms (LUTS) in children with anorectal malformations with rectoperineal fistulas (ARM-P), as compared with healthy controls based on gender.

Method: LUTS were defined using the 2014 definitions of the International Children's Continence Society. Data were collected at 2 tertiary pediatric surgery centers in 2 countries from all children aged 4-12years who had undergone an operation for ARM-P.

Results: A total of 24 girls and 33 boys, with a median age of 8 (4-12)years, were eligible and compared with 165 controls. Of the patient group, 4 (17%) girls had 8 urinary tract anomalies (UTA), and 8 (24%) boys had 13 UTA. There were no gender differences in LUTS among the patients. The frequency of urinary tract infections was higher among the patients (5/24 girls and 7/55 boys) than the controls (1/55 and 4/110) (p=0.009). More patients (5/24 girls and 5/33 boys) than controls (1/55 and 2/110) used daily urinary medications (p=0.009 and p=0.007, respectively). Patients with UTA reported urinary infections more frequently (3/4 girls and 4/8 boys) than those without UTA (2/20 girls and 0/25 boys) (p=0.018 and p=0.002, respectively).

Conclusion: Children with ARM-P had more LUTS than controls, and patients with concomitant UTA had more LUTS than patients without UTA. Therefore, children with ARM-P are suggested to have routine follow-up for both UTA and LUTS.

Keywords: Anorectal malformations (ARM); Perineal fistula, urinary tract, lower urinary tract symptoms (LUTS); Urinary incontinence, urinary tract infection.

MeSH terms

  • Adolescent
  • Anorectal Malformations / complications*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Fistula / complications
  • Humans
  • Lower Urinary Tract Symptoms / etiology*
  • Male
  • Perineum
  • Rectal Fistula / complications*
  • Urinary Tract Infections / etiology*
  • Urogenital Abnormalities / complications

Supplementary concepts

  • Genitourinary Tract Anomalies