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Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations—A Systematic Review

CONTEXT: Long-term urinary and sexual outcomes after repair of anorectal malformations (ARMs) are currently affected by concomitant malformations of the urinary tract and genitalia, sacral anomalies, and the surgical approach. However, the overall prevalence of urinary and sexual dysfunction remains...

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Autores principales: Bjoersum-Meyer, Thomas, Kaalby, Lasse, Lund, Lars, Christensen, Peter, Jakobsen, Marianne S., Baatrup, Gunnar, Qvist, Niels, Ellebaek, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317805/
https://www.ncbi.nlm.nih.gov/pubmed/34337501
http://dx.doi.org/10.1016/j.euros.2021.01.007
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author Bjoersum-Meyer, Thomas
Kaalby, Lasse
Lund, Lars
Christensen, Peter
Jakobsen, Marianne S.
Baatrup, Gunnar
Qvist, Niels
Ellebaek, Mark
author_facet Bjoersum-Meyer, Thomas
Kaalby, Lasse
Lund, Lars
Christensen, Peter
Jakobsen, Marianne S.
Baatrup, Gunnar
Qvist, Niels
Ellebaek, Mark
author_sort Bjoersum-Meyer, Thomas
collection PubMed
description CONTEXT: Long-term urinary and sexual outcomes after repair of anorectal malformations (ARMs) are currently affected by concomitant malformations of the urinary tract and genitalia, sacral anomalies, and the surgical approach. However, the overall prevalence of urinary and sexual dysfunction remains unclear. OBJECTIVE: To evaluate the prevalence of urinary and sexual dysfunction in patients aged >10 yr after repair of ARM in infancy. EVIDENCE ACQUISITION: A systematic literature review was performed using the Medline, Embase, and Cochrane databases. Selected studies were reviewed according to the Consolidated Standards of Reporting Trials (CONSORT) and Standards for the Reporting of Diagnostic Accuracy Studies (STARD) criteria. We included studies reporting the prevalence of the following outcomes: urinary incontinence (UI), lower urinary tract symptoms (LUTS), neurogenic bladder dysfunction (NBD), sexual dysfunction (SD), erectile dysfunction (ED), ejaculatory dysfunction, and birth rate. We initially identified 588 studies, of which 17 were included for evidence synthesis. EVIDENCE SYNTHESIS: A probabilistic meta-analysis on each subgroup revealed the following combined prevalence estimates: UI 16% (95% confidence interval [CI] 7–27%), LUTS/NBD 36% (95% CI 13–62%), SD among women 50% (95% CI 34–66%), ED 12% (95% CI 7–18%), ejaculatory dysfunction 16% (95% CI 9–25%), and birth rate 20% (95% CI 7–38%). Subgroup analysis showed a higher prevalence of ED and ejaculatory dysfunction among patients with high ARM severity when compared to low ARM severity. CONCLUSIONS: Among patients undergoing ARM repair, we found a high prevalence of long-term impairment of UI, ED, and SD. We stress the need for larger multicentre trials with more comparable populations to optimise treatment and follow-up regimens. PATIENT SUMMARY: We reviewed long-term outcomes for patients with anorectal malformations who underwent surgery and found that both urinary incontinence and sexual dysfunctions are common for both males and females.
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spelling pubmed-83178052021-07-29 Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations—A Systematic Review Bjoersum-Meyer, Thomas Kaalby, Lasse Lund, Lars Christensen, Peter Jakobsen, Marianne S. Baatrup, Gunnar Qvist, Niels Ellebaek, Mark Eur Urol Open Sci Review – Voiding Dysfunction CONTEXT: Long-term urinary and sexual outcomes after repair of anorectal malformations (ARMs) are currently affected by concomitant malformations of the urinary tract and genitalia, sacral anomalies, and the surgical approach. However, the overall prevalence of urinary and sexual dysfunction remains unclear. OBJECTIVE: To evaluate the prevalence of urinary and sexual dysfunction in patients aged >10 yr after repair of ARM in infancy. EVIDENCE ACQUISITION: A systematic literature review was performed using the Medline, Embase, and Cochrane databases. Selected studies were reviewed according to the Consolidated Standards of Reporting Trials (CONSORT) and Standards for the Reporting of Diagnostic Accuracy Studies (STARD) criteria. We included studies reporting the prevalence of the following outcomes: urinary incontinence (UI), lower urinary tract symptoms (LUTS), neurogenic bladder dysfunction (NBD), sexual dysfunction (SD), erectile dysfunction (ED), ejaculatory dysfunction, and birth rate. We initially identified 588 studies, of which 17 were included for evidence synthesis. EVIDENCE SYNTHESIS: A probabilistic meta-analysis on each subgroup revealed the following combined prevalence estimates: UI 16% (95% confidence interval [CI] 7–27%), LUTS/NBD 36% (95% CI 13–62%), SD among women 50% (95% CI 34–66%), ED 12% (95% CI 7–18%), ejaculatory dysfunction 16% (95% CI 9–25%), and birth rate 20% (95% CI 7–38%). Subgroup analysis showed a higher prevalence of ED and ejaculatory dysfunction among patients with high ARM severity when compared to low ARM severity. CONCLUSIONS: Among patients undergoing ARM repair, we found a high prevalence of long-term impairment of UI, ED, and SD. We stress the need for larger multicentre trials with more comparable populations to optimise treatment and follow-up regimens. PATIENT SUMMARY: We reviewed long-term outcomes for patients with anorectal malformations who underwent surgery and found that both urinary incontinence and sexual dysfunctions are common for both males and females. Elsevier 2021-02-03 /pmc/articles/PMC8317805/ /pubmed/34337501 http://dx.doi.org/10.1016/j.euros.2021.01.007 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review – Voiding Dysfunction
Bjoersum-Meyer, Thomas
Kaalby, Lasse
Lund, Lars
Christensen, Peter
Jakobsen, Marianne S.
Baatrup, Gunnar
Qvist, Niels
Ellebaek, Mark
Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations—A Systematic Review
title Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations—A Systematic Review
title_full Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations—A Systematic Review
title_fullStr Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations—A Systematic Review
title_full_unstemmed Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations—A Systematic Review
title_short Long-term Functional Urinary and Sexual Outcomes in Patients with Anorectal Malformations—A Systematic Review
title_sort long-term functional urinary and sexual outcomes in patients with anorectal malformations—a systematic review
topic Review – Voiding Dysfunction
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317805/
https://www.ncbi.nlm.nih.gov/pubmed/34337501
http://dx.doi.org/10.1016/j.euros.2021.01.007
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