Impaired fertility and sexual function in patients with anorectal malformations

The review discusses sexual dysfunction and fertility problems in patients with anorectal malformations. Fertility problems in patients with rectal and pelvic abnormalities can develop against the background of concomitant genital malformations and after surgical interventions. Boys often have rectovesical or rectoteurethral (prostatic and bulbar) fistulas. In girls, anorectal malformations may be combined with vaginal atresia and uterine abnormalities leading to impossibility of pregnancy in the future. Psychological aspects have a large effect on sexual dysfunction. Poor results, such as fecal and urine incontinence, have direct influences on social adaptation. In assessing long-term results, multicenter studies have found that, at puberty, one-third of women and >10% of men had problems with their sexual function because of low self-esteem and impaired social adjustment. Anorectal malformations are not current problems in pediatric surgery. Patients need an interdisciplinary, personalized approach that includes timely diagnosis and surgical correction of defects, as well as detection and correction of disorders of anatomy of pelvic organs and internal and external genitalia.