INFLUENCE OF DISEASE ON THE QUALITY OF LIFE OF PATIENTS WITH EXTRASPHINCTERIC AND TRANSSPHINCTERIC PARARECTAL FISTULAS

Abstract

Relevance. The presence of high transsphincteric and extrasphincteric anal fistulas can cause severe local changes such as significant deformation of the anal canal, perineum, and resulting in anal incontinence, which significantly impairs the quality of life of these patients. Objectives: to evaluate the quality of life of patients with chronic paraproctitis, using a comparative analysis of the studied groups. Objects and methods. The study involved 58 patients who had different forms of chronic paraproctitis treated in proctology department of M.V. Sklifosovsky Poltava Regional Clinical Hospital and in the surgical department of Poltava City Clinical Hospital #3. Results. While studying the anamnesis, it was found that the duration of the disease in patients varied from 2-3 months to 10 years or more, an average of 2.9 ± 0.9 years. Patients involved in physical labour made up 82.7%, slightly fewer patients were engaged in mental work, 20.6%, even less people were involved in combined type of activity, 10.4%. In 32 (55.2%) patients, other coloproctological diseases were detected, and some of them had 3 or more diseases at the same time. The most common complaint (100%) was the presence of an external fistulous aperture in the perianal region. Pain was reported by 48 (82.8%) people. In this case, it was also found that the frequency of this complaint increased with a longer medical history (76.2% in patients with anamnesis up to 1 year, compared with 92.9% in patients with chronic paraproctitis over 5 years). In 22 (37.9%) patients there were complaints of a periodic increase in body temperature that is associated with an aggravation of the chronic process. Conclusion. Thus, most patients search for medical care in the late stages of the disease - on the average 3 years after the onset of the first symptoms. Moreover, in patients with a long history of the disease, symptoms become more severe that significantly impairs the quality of their lives. The vast majority of patients with anal fistulas are engaged in physical labour, and it is the fact that the pain in chronic paraproctitis exacerbated during physical activity makes patients with this pathology ask for medical aid.