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The genitourinary system in patients with imperforate anus
G A McLorie1, C A Sheldon, M Fleisher
1Division of Pediatric Urology, Hospital for Sick Children, Toronto, Ontario.
Insights
Infants with imperforate anus often have genitourinary abnormalities. Early detection of conditions like vesicoureteral reflex and neurovesical dysfunction is crucial for preventing kidney damage.
Area of Science:
- Pediatric Surgery
- Urology
- Nephrology
Background:
- Imperforate anus is a congenital condition that can be associated with other anomalies.
- Genitourinary abnormalities are common in infants diagnosed with imperforate anus.
- Understanding these associated conditions is vital for comprehensive patient care.
Purpose of the Study:
- To review the incidence and significance of genitourinary abnormalities in infants with imperforate anus.
- To identify patterns of urinary tract anomalies and their impact on renal health.
- To highlight preventable causes of renal deterioration in this patient population.
Main Methods:
- Retrospective review of 484 infants diagnosed with imperforate anus over a 17-year period.
- Analysis of the types and severity of associated genitourinary abnormalities.
- Categorization of renal pathologies and assessment of preventable risk factors.
Main Results:
- Fourteen percent of infants presented with significant bilateral upper tract urinary abnormalities.
- A subset of these patients (14 out of 67) had uncorrectable renal pathology such as renal agenesis or hypoplasia-dysplasia.
- High incidences of vesicoureteral reflex and neurovesical dysfunction were observed.
Conclusions:
- Associated genitourinary abnormalities are frequent in infants with imperforate anus.
- Vesicoureteral reflex and neurovesical dysfunction are significant, potentially preventable causes of renal deterioration.
- Multidisciplinary management is essential to address these associated anomalies and preserve renal function.
Abstract:
The incidence and significance of associated genitourinary abnormalities was reviewed in a series of 484 infants with imperforate anus encountered over a 17-year period. Fourteen percent of the entire series had significant bilateral upper tract urinary abnormalities (either asymmetric or symmetric). Of 67 such patients only 14 had combinations of renal agenesis and hypoplasia-dysplasia representing uncorrectable renal pathology. A high incidence of vesicoureteral reflex and neurovesical dysfunction represent additional important sources of preventable renal deterioration.