title: Lower urinary tract symptoms in children with anorectal malformations with rectoperineal fistulas.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatric Surgery, Skane University Hospital, Institution of Clinical Science, Lund University. Electronic address: pernilla.stenstrom@med.lu.se.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Stenström
authors.affiliation: Faculty of Medicine, Lund University. Electronic address: hanna.sandelin@hotmail.com.
authors.forename: Hanna
authors.initials: H
authors.lastname: Sandelin
authors.affiliation: Department of Pediatric Surgery, Oslo University Hospital Rikshospitalet, University of Oslo. Electronic address: ragnhild.emblem@oslo-universitetssykehus.no.
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Emblem
authors.affiliation: Department of Pediatric Surgery, Oslo University Hospital Rikshospitalet, University of Oslo. Electronic address: kristin.bjornland@oslo-universitetssykehus.no.
authors.forename: Kristin
authors.initials: K
authors.lastname: Björnland
mesh_terms: D000293:Adolescent; D000071056:Anorectal Malformations / Q000150:complications*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005402:Fistula / Q000150:complications; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology*; D008297:Male; D010502:Perineum; D012003:Rectal Fistula / Q000150:complications*; D014552:Urinary Tract Infections / Q000209:etiology*; D014564:Urogenital Abnormalities / Q000150:complications
keywords: Anorectal malformations (ARM); Perineal fistula, urinary tract, lower urinary tract symptoms (LUTS); Urinary incontinence, urinary tract infection