Rectoanal pressure studies and postoperative continence in imperforate anus

Functional results after surgical correction of anorectal malformations were assessed on a clinical basis using the Kelly score and by manometric study. In all, 65 patients, aged 5-28 years, were interviewed personally, and 51 of these 65 had manometric studies to evaluate postoperative continence. The manometric study was also performed on 45 normal children as control group. Continent patients characteristically had a marked high-pressure zone, as did the normal subjects. On the other hand, in the patients with fair or poor results, the anorectal pressure profile had no marked high-pressure zone in the anal canal. The presence of normal anal pressure at rest as well as adequate anorectal pressure difference was found to correlate well with continence. In the patients with perineoplasty, the anorectal reflex correlated well with continence, but not in patients treated by abdominoperineal rectoplasty.