Lower urinary tract symptoms and sexual functions after endorectal pull-through for Hirschsprung disease: controlled long-term outcomes.
OBJECTIVE
To define the prevalence of lower urinary tract symptoms (LUTS) and outcomes for sexual function after endorectal pull-through (EPT) for Hirschsprung disease (HD) compared to controls. To date, similar controlled studies are lacking.


METHODS
Patients aged ≥4years (n=123) operated on for HD at our center between 1987 and 2011 were invited to answer questionnaires on LUTS and sexual function (aged ≥16years). Patients with an intellectual disability and patients with a definitive endostomy were excluded. Patients were matched to three controls and also invited to a clinical follow-up for urological investigations including urine flow measurement, renal tract ultrasound, and urinalysis.


RESULTS
Altogether, 59 responses concerning LUTS and 24 responses concerning sexual functions were analyzed. No significant differences were demonstrated in the overall prevalence of LUTS between patients (67%) and controls (80%), nor in the prevalence of frequent LUTS (14% vs. 16%; P=NS for both). One patient (2%) had a urethral stricture after laparotomy-assisted EPT. Male patients reported sexual satisfaction and erectile function similar to controls (P>0.10). Female patients were currently less in stable relationships compared to controls (25% vs. 83%, P=0.005).


CONCLUSIONS
Our results support the safety of EPT in patients with HD with regard to preservation of the integrity and functioning of the genitourinary tract.
Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Finland. Electronic address: malla.neuvonen@helsinki.fi.
Malla
M
Neuvonen
Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Finland.
Kristiina
K
Kyrklund
Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Finland.
Seppo
S
Taskinen
Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Finland.
Antti
A
Koivusalo
Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Finland.
Risto J
RJ
Rintala
Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Finland.
Mikko P
MP
Pakarinen
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects*; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011183:Postoperative Complications; D015995:Prevalence; D012212:Rheology; D012725:Sexual Behavior / Q000502:physiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014563:Urodynamics; D055815:Young Adult
Endorectal pull-through; Hirschsprung's disease; LUTS; Sexual function