Purpose: The aim of this study was to investigate influences of fecal incontinence on children's quality of life after surgically corrected anorectal malformation.
Methods: Seventy-one children with anorectal malformation underwent follow-up for 8 to 16 years postoperatively. They were divided into good, fair, and poor groups by assessment of anal function. The quality of life was investigated by self-structured disease impact questionnaires and Achenbach's Child Behavior Check List (CBCL). A quality-of-life scoring criteria was established to assess quality of life of the 71 children with operated anorectal malformation and controls.
Results: Owing to fecal incontinence, 12 (16.9%) children reported that there were problems in peer relationships; school absences happened in 13 (18.3%) children; 17 (23.9%) children had to restrict themselves to certain food. Based on CBCL, 13 (18.3%) children had behavior problems. The behavior problems in children with poor fecal continence (66.7%) were significantly higher than those of children with good fecal continence (8.6%). According to the quality-of-life scoring criteria, the scores of children with operated anorectal malformation (9.4+/-3.7) were significantly lower than those of the controls (11.2+/-0.9). The scores of children with poor fecal continence (4.8+/-1.4) were significantly lower than those of children with good fecal continence (10.9+/-1.2).
Conclusions: The children with poor fecal continence have poor quality of life caused by fecal dysfunction. Attention should be paid to the rehabilitation of fecal continence after surgery, such as bowel training and biofeedback therapy. The somatic and psychological care and long-term follow-up are necessary to improve the quality of life.