Davidson Joseph R, Mutanen Annika, Granström Anna Löf, Hoel Anders Telle, Loukogeorgakis Stavros P, De Coppi Paolo, Bjørnland Kristin, Wester Tomas, Eaton Simon, Pakarinen Mikko P, Curry Joe
Great Ormond Street Hospital for Children, London, UK.
UCL Great Ormond Street Institute of Child Health, London, UK.
BJOG. 2025 Oct;132(11):1673-1680. doi: 10.1111/1471-0528.18294. Epub 2025 Jul 10.
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).
International multicentre cross-sectional cohort study with comparison to controls from the general population.
Status post-discharge from paediatric services.
Female patients aged > 20 years.
Validated questionnaire-based survey with linkage to patient medical records. Comparison with controls using univariate analyses.
Sexual dysfunction (Female Sexual Function Index; FSFI ≤ 26), Subfertility at 1 and 2 years.
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.
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.
先天性巨结肠是一种影响胃肠道的先天性疾病。然而，有假说认为婴儿期的盆腔结直肠手术会对其成年后的妇科结局产生影响。描述先天性巨结肠病女性与一般人群对照者的性功能和生育结局。评估与不良结局（性功能障碍和生育力低下）相关的因素。
国际多中心横断面队列研究，并与一般人群对照者进行比较。
儿科服务出院后状态。
年龄大于20岁的女性患者。
基于问卷的有效调查，并与患者病历相联系。采用单因素分析与对照者进行比较。
性功能障碍（女性性功能指数；FSFI≤26）、1年和2年时的生育力低下。
根据FSFI，性功能障碍在患者中更常见，且与不良功能结局相关；性禁欲似乎与不良肠道结局的关联更强。与对照者相比，患者的生育力低下情况更严重（1年时：21/45（47%）对38/178（21%），p = 0.0008；2年时：12/45（27%）对17/178（10%），p = 0.004）。使用生育服务的患者比例增加（20/45（44%）对43/178（24%）；p = 0.009），尝试通过体外受精受孕的患者中成功妊娠的比例（11/17（65%）对27/43（63%）；p = 1.0）相似。
这些新数据表明，接受过重建手术的先天性巨结肠病女性可能面临性功能和生育结局不良的风险。
