Abstract：
OBJECTIVE: We conducted a nationwide survey of persistent cloaca (PC) to determine its current status in Japan. This study clarifies the potential risk factors for defecation problems in patients with PC.
METHODS: Patient information was obtained via questionnaire, and a total of 213 PC patients who responded to a questionnaire on defecation problems and their bowel functions were enrolled in this study. We evaluated the constipation, incontinence, and soiling as bowel functions. Univariate and multivariate analyses were performed using a logistic regression analysis to clarify the risk factors for defecation problems.
RESULTS: Of 213 patients with PC, 55 (25.8%) had defecation problems. A multivariate logistic regression analysis showed that sacral agenesis, as an associated anomaly, was significantly associated with defecation problems (odds ratio [OR] 3.19, 95% confidence interval [CI] 1.11-9.16, p = 0.03). The other multivariate logistic regression analysis showed that the PC patients who underwent antegrade continence enema and regularly took laxatives after anorectoplasty had defecation problems (OR 12.4, 95% CI 2.35-65.6, p = 0.003, OR 2.84, 95% CI 1.24-6.55, p = 0.01).
CONCLUSIONS: Sacral agenesis is the potential risk factor of defecation problems in the patients with PC who underwent anorectoplasty. Those patients require vigorous defecation management.
METHODS: Patient information was obtained via questionnaire, and a total of 213 PC patients who responded to a questionnaire on defecation problems and their bowel functions were enrolled in this study. We evaluated the constipation, incontinence, and soiling as bowel functions. Univariate and multivariate analyses were performed using a logistic regression analysis to clarify the risk factors for defecation problems.
RESULTS: Of 213 patients with PC, 55 (25.8%) had defecation problems. A multivariate logistic regression analysis showed that sacral agenesis, as an associated anomaly, was significantly associated with defecation problems (odds ratio [OR] 3.19, 95% confidence interval [CI] 1.11-9.16, p = 0.03). The other multivariate logistic regression analysis showed that the PC patients who underwent antegrade continence enema and regularly took laxatives after anorectoplasty had defecation problems (OR 12.4, 95% CI 2.35-65.6, p = 0.003, OR 2.84, 95% CI 1.24-6.55, p = 0.01).
CONCLUSIONS: Sacral agenesis is the potential risk factor of defecation problems in the patients with PC who underwent anorectoplasty. Those patients require vigorous defecation management.
摘要：
目的：我们对持久性泄殖腔（PC）进行了全国性调查，以确定其在日本的现状。这项研究阐明了PC患者排便问题的潜在危险因素。
方法：通过问卷调查获得患者信息，本研究纳入了213名接受排便问题和肠道功能调查问卷的PC患者。我们评估了便秘，失禁,并污染肠道功能。使用逻辑回归分析进行单变量和多变量分析，以阐明排便问题的危险因素。
结果：在213例PC患者中，55（25.8％）有排便问题。多因素logistic回归分析显示骶骨发育不全,作为相关的异常，与排便问题显著相关(比值比[OR]3.19,95%置信区间[CI]1.11-9.16,p=0.03)。其他多因素logistic回归分析显示，在肛门直肠成形术后进行顺行失禁灌肠并定期服用泻药的PC患者排便问题（OR12.4，95％CI2.35-65.6，p=0.003，OR2.84，95％CI1.24-6.55，p=0.01）。
结论：骶骨发育不全是接受肛门直肠成形术的PC患者排便问题的潜在危险因素。这些患者需要大力排便管理。
方法：通过问卷调查获得患者信息，本研究纳入了213名接受排便问题和肠道功能调查问卷的PC患者。我们评估了便秘，失禁,并污染肠道功能。使用逻辑回归分析进行单变量和多变量分析，以阐明排便问题的危险因素。
结果：在213例PC患者中，55（25.8％）有排便问题。多因素logistic回归分析显示骶骨发育不全,作为相关的异常，与排便问题显著相关(比值比[OR]3.19,95%置信区间[CI]1.11-9.16,p=0.03)。其他多因素logistic回归分析显示，在肛门直肠成形术后进行顺行失禁灌肠并定期服用泻药的PC患者排便问题（OR12.4，95％CI2.35-65.6，p=0.003，OR2.84，95％CI1.24-6.55，p=0.01）。
结论：骶骨发育不全是接受肛门直肠成形术的PC患者排便问题的潜在危险因素。这些患者需要大力排便管理。
