Kremer Marijke E B, Derikx Joep P M, van Baren Robertine, Heij Hugo A, Wijnen Marc H W A, Wijnen René M H, van der Zee David C, van Heurn Ernest L W E
Department of Pediatric Surgery, Maastricht University Medical Center, The Netherlands.
Department of Pediatric Surgery, University Medical Center Groningen, The Netherlands.
Pediatr Blood Cancer. 2016 Apr;63(4):690-4. doi: 10.1002/pbc.25857. Epub 2016 Jan 6.
To evaluate defecation and micturition complaints in adults treated for sacrococcygeal teratoma (SCT) during childhood and to identify risk factors for soiling, urinary incontinence, and constipation beyond childhood.
Records of patients aged ≥18 treated for SCT during infancy in the Netherlands were retrospectively reviewed. Frequency and severity of soiling, constipation, and urinary incontinence were evaluated using questionnaires designed in line with the Krickenbeck classification. Problems during childhood were compared to outcomes at adult age in part of the cohort. Associations between patient- and disease-related factors with complaints beyond childhood were analyzed with the chi-square test or Fisher's exact test, when appropriate.
Of 47 included patients (mean age 26.2 years, SD ±6.5), 49% reported at least one defecation or micturition complaint. Urinary incontinence was present in 30% and had a greater negative impact than soiling (24%). Ten patients (21%) reported constipation; five found this severely bothering. Three patients reported social restrictions due to defecation or micturition complaints (6.4%). While sex and tumor histology were not identified as risk factors, a tumor diameter of >10 cm and Altman type I or type II SCT were associated with constipation during adulthood.
One-third of the patients treated for SCT during childhood reported urinary and defecation problems beyond childhood. In only a minority of cases, these led to social restrictions. A greater tumor diameter was associated with a higher risk of constipation during adulthood. Prolonged surveillance strategies are advised for all patients with SCT.
评估童年期接受骶尾部畸胎瘤（SCT）治疗的成年人的排便和排尿主诉，并确定儿童期后出现便失禁、尿失禁和便秘的危险因素。
回顾性分析荷兰婴儿期接受SCT治疗且年龄≥18岁患者的记录。使用根据克里肯贝克分类法设计的问卷评估便失禁、便秘和尿失禁的频率及严重程度。在部分队列中，将儿童期的问题与成年后的结果进行比较。在适当情况下，采用卡方检验或费舍尔精确检验分析患者及疾病相关因素与儿童期后主诉之间的关联。
47例纳入患者（平均年龄26.2岁，标准差±6.5）中，49%报告至少有一项排便或排尿主诉。30%存在尿失禁，其负面影响大于便失禁（24%）。10例患者（21%）报告便秘，其中5例认为严重困扰。3例患者报告因排便或排尿主诉导致社交受限（6.4%）。虽然性别和肿瘤组织学未被确定为危险因素，但肿瘤直径>10 cm以及奥特曼I型或II型SCT与成年期便秘相关。
童年期接受SCT治疗的患者中有三分之一报告儿童期后存在泌尿和排便问题。仅在少数情况下，这些问题导致社交受限。更大的肿瘤直径与成年期便秘风险较高相关。建议对所有SCT患者采取长期监测策略。
