Impaired Fertility and Sexual Function in Women With Hirschsprung Disease: Results From an International Multi-Centre Cross-Sectional Study

IF 4.3 1区医学 Q1 OBSTETRICS & GYNECOLOGY

Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2025-07-10 DOI:10.1111/1471-0528.18294

Joseph R. Davidson, Annika Mutanen, Anna Löf Granström, Anders Telle Hoel, Stavros P. Loukogeorgakis, Paolo De Coppi, Kristin Bjørnland, Tomas Wester, Simon Eaton, Mikko P. Pakarinen, Joe Curry

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Abstract

Objective

Hirschsprung is a congenital disorder affecting the gastrointestinal tract. However, pelvic colorectal surgery in infancy has been hypothesised to impact gynaecological outcomes in later life. Describe sexual function and fertility outcomes in women with Hirschsprung disease compared to population controls. Assess factors associated with poor outcomes (sexual dysfunction and subfertility).

Design

International multicentre cross-sectional cohort study with comparison to controls from the general population.

Setting

Status post-discharge from paediatric services.

Population

Female patients aged > 20 years.

Methods

Validated questionnaire-based survey with linkage to patient medical records. Comparison with controls using univariate analyses.

Main Outcome Measures

Sexual dysfunction (Female Sexual Function Index; FSFI ≤ 26), Subfertility at 1 and 2 years.

Results

Sexual dysfunction as per the FSFI was more common in patients and associated with poor functional outcomes; sexual abstinence seemed to associate even more so with poor bowel outcomes. Subfertility was higher in patients compared to controls (1 year: 21/45 (47%) vs. 38/178 (21%), p = 0.0008; 2 years: 12/45 (27%) vs. 17/178 (10%), p = 0.004). There was an increased proportion of patients who had accessed fertility services (20/45 (44%) vs. 43/178 (24%); p = 0.009), the proportion of successful pregnancies in patients attempting to conceive with IVF (11/17 (65%) vs. 27/43 (63%); p = 1.0) was similar.

Conclusions

These novel data suggest that women with Hirschsprung disease who have undergone reconstructive surgery may be at risk for adverse sexual function and fertility outcomes.

Abstract Image

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一项国际多中心横断面研究的结果显示，患有巨结肠疾病的女性生育能力和性功能受损

目的先天性巨结肠是一种影响胃肠道的先天性疾病。然而，婴儿期盆腔结直肠手术被假设会影响以后生活中的妇科结果。描述与人口对照组相比，患有先天性巨结肠疾病的妇女的性功能和生育结果。评估与不良预后相关的因素（性功能障碍和生育能力低下）。设计国际多中心横断面队列研究，与普通人群对照进行比较。从儿科服务出院后的状况。人群：年龄>；20年。方法采用经验证的问卷调查，并与患者病历相联系。采用单变量分析与对照比较。性功能障碍(女性性功能指数；FSFI≤26)，1岁和2岁不孕。结果根据FSFI，性功能障碍在患者中更为常见，并与较差的功能预后相关；性节制似乎与排便不良的关系更大。与对照组相比，低生育能力患者更高(1年：21/45（47%）比38/178 (21%),p = 0.0008；2年：12/45 (27%)vs. 17/178 (10%), p = 0.004。接受生育服务的患者比例增加(20/45 (44%)vs. 43/178 (24%)；p = 0.009)，尝试IVF怀孕的患者成功怀孕的比例(11/17 (65%)vs. 27/43 (63%)；P = 1.0)相似。结论：这些新数据表明，患有巨结肠疾病的女性接受了重建手术，可能存在不良性功能和生育结果的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bjog-An International Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

10.90

自引率

5.20%

发文量

345

审稿时长

3-6 weeks

期刊介绍： BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.