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Impaired Fertility and Sexual Function in Women with Hirschsprung disease: Results from an international multi-centre cross-sectional study.
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  • Joseph Davidson,
  • Annika Mutanen,
  • Anna Löf Granström,
  • Anders Telle Hoel,
  • Stavros Loukogeorgakis P,
  • Paolo De Coppi,
  • Kristin Bjørnland,
  • Tomas Wester,
  • Simon Eaton,
  • Mikko Pakarinen P,
  • Joe Curry
Joseph Davidson
University College London Great Ormond Street Institute of Child Health

Corresponding Author:joseph.davidson@ucl.ac.uk

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Annika Mutanen
Uusi lastensairaala
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Anna Löf Granström
Karolinska University Hospital
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Anders Telle Hoel
Oslo universitetssykehus
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Stavros Loukogeorgakis P
University College London Great Ormond Street Institute of Child Health
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Paolo De Coppi
University College London Great Ormond Street Institute of Child Health
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Kristin Bjørnland
Oslo universitetssykehus
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Tomas Wester
Karolinska University Hospital
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Simon Eaton
University College London Great Ormond Street Institute of Child Health
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Mikko Pakarinen P
Uusi lastensairaala
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Joe Curry
Great Ormond Street Hospital for Children NHS Foundation Trust
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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 population-matched controls 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 Mann-Whitney and Fisher’s Exact tests. Multivariable logistic regression using outcomes of sexual dysfunction and subfertility. 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 moreso 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), however the proportion of successful pregnancies in patients attempting to conceive with IVF (11/17 (65%) vs 27/43 (63%); p=1.0) were similar. Conclusions: This novel data suggests that women with Hirschsprung disease who have undergone reconstructive surgery may be at risk for adverse sexual functional and fertility outcomes.
01 Aug 2024Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
14 Aug 2024Submission Checks Completed
14 Aug 2024Assigned to Editor
14 Aug 2024Review(s) Completed, Editorial Evaluation Pending
21 Aug 2024Reviewer(s) Assigned