assessment of sacral ratio in patients with fecal incontinence and its correlation with treatment response among iranian pediatric patients

Background and objective: fecal incontinence (fi) is a multifactorial condition characterized by involuntary fecal excretion, impacting quality of life. approximately 1 in 12 adults worldwide suffer from fi, with a higher prevalence among women and the elderly. fi patients often experience physical and psychological problems, including infections, skin issues, and social anxiety. sacral anomalies may contribute to fi, and the sacral ratio (sr) is a reliable metric for evaluating sacral development in anorectal malformations. this study aims to investigate changes in sr among children with fi to assess its role in fi diagnosis and prediction.methods: this case-control study was conducted on 288 children aged 4-18 years referred to mofid children’s hospital in tehran, iran. the data were analyzed using spss software to control for confounders. demographic data, fi condition, and radiological findings were evaluated, and sr values were compared between the case and control groups.results: the study involved 288 children (158 females, 130 males). the average age for the fi group was 7.12 ± 2.57 years, and for the control group, it was 8.56 ± 2.89 years. the overall sr was 0.6760 ± 0.12369 with a confidence interval of 0.6616 to 0.6904. the control group had a higher sr (0.6968 ± 0.10) compared to the fi group (0.65 ± 0.13), with a significant difference between groups (effect size: cohen’s d = 0.34, p-value = 0.005). nine subjects in the case group did not respond to treatment. sr (p=0.993) and sex (p=0.237) were not significantly associated with response to treatmentconclusion: this study highlights the complex role of sr in the field of pediatric fi, emphasizing the need for a nuanced, multidisciplinary approach to address this challenging clinical condition. continued research in this area will undoubtedly advance our understanding and lead to more targeted and effective interventions for affected children.