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Magnetic resonance imaging of the anal sphincter and spine in patients with anorectal malformations after posterior sagittal anorectoplasty: a late follow-up cross-sectional study

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Abstract

Purpose

We aimed to assess the association of fecal incontinence to the anatomy of the anal sphincter complex and lower bony spinal anomalies as investigated with magnetic resonance imaging (MRI) in adolescents and adults with anorectal malformations (ARM) after posterior sagittal anorectoplasty (PSARP).

Methods

We conducted a cross-sectional study in 20 patients with ARM after PSARP. Anatomy of the anorectum and spine were examined with MRI and functional outcome assessed with the Wexner incontinence score.

Results

We included 20 patient (12 males) had a median age of 19.5 years (14–27). One patient was excluded leaving 19 patients for outcome analysis. Fecal incontinence was found in 12 out of 19 patients (63%). Interposed fat was present in 9 patients (47%). The presence (r = 0.597, p = 0.012) and thickness of interposed fat (r = 0.832, p = 0.005) between the anal sphincter complex and bowel were positively correlated to the Wexner fecal incontinence score. No correlation was found between lower bony spinal anomalies and fecal incontinence.

Conclusions

A positive correlation between interposed fat and higher Wexner fecal incontinence score was found indicating a more severe fecal incontinence but no other correlation between anatomy of the anal sphincter complex and neorectum to functional bowel outcome was observed.

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Data availability

Further data on demographics and MRI are available upon request from corresponding author.

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Funding

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Authors and Affiliations

  1. Department of Surgery, Odense University Hospital, 5000, Odense C, Denmark

    Thomas Bjørsum-Meyer, Gunnar Baatrup & Niels Qvist

  2. Faculty of Health Science, Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark

    Thomas Bjørsum-Meyer, Gunnar Baatrup & Niels Qvist

  3. Department of Surgery, Aarhus University Hospital, 9000, Aarhus, Denmark

    Peter Christensen

  4. Department of Pediatrics, Odense University Hospital, 5000, Odense, Denmark

    Marianne Skytte Jakobsen

  5. Department of Radiology, Odense University Hospital, 5000, Odense, Denmark

    Jon Asmussen

Authors
  1. Thomas Bjørsum-Meyer
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  2. Peter Christensen
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  3. Gunnar Baatrup
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  4. Marianne Skytte Jakobsen
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  5. Jon Asmussen
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  6. Niels Qvist
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Contributions

TBM and NQ conceived and designed the study. TBM performed the logistic work and performed the examinations. TBM and NQ analyzed the data. All authors wrote and critically reviewed the manuscript.

Corresponding author

Correspondence to Thomas Bjørsum-Meyer.

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The authors declare that they have no conflict of interest.

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Verbal and written informed consent was obtained from all individual participants included in the study. In minors, informed consent was obtained from the parents.

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The authors affirm that participants provided informed consent for publication of the images in Fig. 1.

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Bjørsum-Meyer, T., Christensen, P., Baatrup, G. et al. Magnetic resonance imaging of the anal sphincter and spine in patients with anorectal malformations after posterior sagittal anorectoplasty: a late follow-up cross-sectional study. Pediatr Surg Int 37, 85–91 (2021). https://doi.org/10.1007/s00383-020-04774-1

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  • DOI: https://doi.org/10.1007/s00383-020-04774-1

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