Factors affecting the quality of life of patients with anorectal malformation in adulthood

Aim: In this study, we aimed to reveal the factors affecting bowel functions and quality of life in patients who were operated for anorectal malformation and transitioned to adulthood.

Methods: Forty-six patients aged 18-37 years, who were followed up and treated in our clinic between 1985 and 2004, were evaluated in terms of demographic characteristics, anorectal malformation type, fecal con- tinence, urinary pathologies, sacral and spinal anomalies, and quality of life. The Krickenbeck scoring was used. A questionnaire containing age-appropriate questions, known as the pediatric general quality of life scale (PedsQL), was administered to the patients.

Results: The mean age (±SD) of the patients was 21.21 ± 3.85 years, 27 (58.6%) were male. Rectobulbar and rectoprostatic fistula were most common in boys (77.7%), and rectovestibular fistulas were most common in girls (76.4%). 21 (45.6%) of the patients were working in a job, 7 (15.2%) were not working at any job, and 18 (39.2%) were students. There were 7 patients (4 male, 3 female) who were married. Five of them had children. Two female patients don’t have children. The mean age of patients to become fully continent was 8.11.

In the Krickenbeck scoring, there were 36 patients in Stage 1, 7 patients in Stage 2, and 3 patients in Stage 3. It was observed that there was a significant decrease in PedsQL from Stage 1 to Stage 3. PedsQL values of 9 patients with severe uropathy were lower than the others. PedsQL values of 11 patients with sacral and spinal cord pathology were lower than the others.

Conclusion: In our study, we determined that approximately three-quarters of patients had a good Krick- enbeck continence score. It was observed that fecal continence, serious urinary system pathologies, sacral and spinal cord anomalies adversely affected the quality of life in adulthood.