EP1089 - Implementing Routine Patient Reported Outcome Measures (PROMs) for Anorectal Conditions: Feasibility and Outcomes

Monday, May 11, 2026

4:19 PM - 4:24 PM ET

ePoster Presenter(s)

MA

Marta Antoniv, MD (she/her/hers)

Research Fellow
Brigham and Women's Hospital
Brigham and Women's Hospital, Harvard Medical School
Boston, MA, United States

Disclosure information not submitted.

Senior Author(s)

Ronald Bleday, M.D.

Chief of Colorectal Surgery
Brigham and Woman's Hospital
Boston, Massachusetts, United States

Disclosure information not submitted.

Author(s)

DS

Daniel Stoltz, MD

Colon and Rectal Surgery Fellow
Brigham and Women's Hospital
Boston, Massachusetts, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no relevant relationships with ineligible companies.
Liliana Bordeianou, MD, MPHFASCRS

Professor of Surgery
Harvard Medical School; Mass General Brigham Division Colon and Rectal Surgery
Harvard
Boston, MA, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no relevant relationships with ineligible companies.
JG

Joel E. Goldberg, MD, MPH

Colorectal Surgeon
Brigham and Women's Hospital
Boston, Massachusetts, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Daniel Stoltz, MD: This individual has no relevant relationships with ineligible companies.

Liliana Bordeianou, MD, FASCRS: This individual has no relevant relationships with ineligible companies.

Purpose/Background: Patient-reported outcome measures (PROMs) quantify symptom burden and disease-specific quality of life in anorectal disease and are increasingly used to evaluate surgical benefit. This study aimed to assess the feasibility of routine PROM capture, determine the optimal timing for follow-up, and evaluate pre- and post-changes in patients with hemorrhoidal disease and anal fistula.

Methods/Interventions: We conducted a retrospective analysis of prospectively collected cohort data for patients treated for hemorrhoids or anal fistula (April-September 2025). PROMs were obtained as part of routine care at two timepoints: preoperative (before the index operation) and postoperative (during follow-up). The Hemorrhoidal Disease Symptom Score (HDSS) was used for hemorrhoids, and the Quality of Life in Patients with Anal Fistula Questionnaire (QOLAF-Q) for fistula. Clinical outcomes were abstracted retrospectively: the presence of prolapse was recorded for hemorrhoids, and the degree of healing was recorded for anal fistula. For patients with paired PROMs, changes were summarized with medians and IQRs and tested with the Wilcoxon signed-rank test.

Results/Outcomes: We analyzed 120 patients: 64 (53.3%) with hemorrhoids and 56 (46.7%) with anal fistula. A postoperative PROM was completed by 11 out of 64 hemorrhoid patients (17.2%) and 10 out of 56 fistula patients (17.9%). Among those with follow-up PROMs, the surgery-to-PROM interval had a median of 31.5 days for hemorrhoids (IQR 30.0-66.8) and 76.0 days for fistula (IQR 42.0-76.0). Paired PROMs showed significant improvement: in hemorrhoid disease, HDSS decreased by a median of -6.0 points (IQR -12.0 to -2.0; n=17; p=0.0012), and in anal fistula, QOLAF-Q decreased by a median of -7.0 points (IQR -8.0 to -5.0; n=13; p=0.0024). Outcome documentation indicated no prolapse in 100% of hemorrhoid cases. In the anal fistula, follow-up outcomes indicated that the fistula was closed in 46.4% of cases, partially closed in 42.9%, and not closed in 10.7%.

Conclusion/Discussion: The routine collection of anorectal PROMs was feasible and demonstrated statistically and clinically significant improvements in symptoms (HDSS) and disease-specific quality of life (QOLAF-Q). These findings support wider implementation of routine PROMs and motivate procedure-stratified analyses in larger cohorts.