More harm than good? Parental perspectives on dilatations in anorectal malformations

PMCID: PMC12178956

PMID: 40536563

DOI: 10.1007/s00383-025-06070-2

Journal: Pediatric surgery international

Publication Date: 2025-6-19

Authors: Barros AI, Correia MR, Carvalho F, Bonet B, Carvalho C

Key Points

• 62.5% of caregivers reported emotional distress during anal dilations
• 54.2% of parents experienced difficulty performing home-based anal dilations
• The study supports re-evaluating the routine use of anal dilations in ARM patients due to psychological burden

Summary

This study investigated the psychological impact of anal dilations (AD) in patients with anorectal malformations (ARM), challenging the traditional post-operative management approach. Through a telephone questionnaire of 32 caregivers of ARM patients, researchers explored the emotional and practical challenges associated with routine anal dilations. The study population included children with a median age of 5 months at surgery and 10.5 years at survey, with ARM with perineal fistula being the most common subtype.

The findings revealed significant psychological distress for both caregivers and patients. Approximately 54.2% of parents reported difficulty performing home-based anal dilations, with two-thirds requiring assistance. Notably, 62.5% of caregivers experienced emotional distress during the procedure, and 75% perceived discomfort in their children. Overall, 28.1% of respondents reported a negative psychological impact, suggesting that routine anal dilations may cause more harm than benefit.