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The effect of rectourogenital fistula in high imperforate anus

Ibrahim Daradka1, Issa Hazza

  • 1Department of Pediatrics, King Hussein Medical Center, Amman, Jordan. didaradka@yahoo.com.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|May 15, 2007
PubMed

Insights

Rectourogenital fistulae are common in high imperforate anus cases, impacting bowel control. Their presence is a new prognostic factor for anorectal function requiring further study.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Gastroenterology

Background:

  • High imperforate anus is a congenital condition requiring surgical correction.
  • Rectourogenital fistulae can complicate high imperforate anus, potentially affecting functional outcomes.

Purpose of the Study:

  • To determine the incidence of rectourogenital fistulae in patients with high imperforate anus.
  • To investigate the role of these fistulae in the mechanism of defecation and overall anorectal function.

Main Methods:

  • Retrospective study of 42 children (38 males, 4 females) with high imperforate anus (1982-1995).
  • Radiological evaluation for rectal pouch level and spinal anomalies.
  • Preliminary colostomy, ultrasonography for renal/ureteral assessment, and posterior sagittal anorectoplasty.
  • Clinical assessment of bowel control (voluntary bowel movements, soiling, incontinence, constipation).

Main Results:

  • Eighteen patients (42.8%) had rectourogenital fistulae (15 rectourethral, 2 rectovaginal, 1 rectovesical).
  • Among 36 patients with known outcomes, 41.6% had voluntary bowel movements, 25% experienced soiling, and 16.6% had constipation or incontinence.

Conclusions:

  • The presence of rectourogenital fistulae is a significant factor in high imperforate anus.
  • Fistula presence may represent a novel prognostic indicator for long-term anorectal function in these patients.

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