Related Experiment Video

Updated: Aug 5, 2026

Vessel-sparing Excision and Primary Anastomosis
08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Postoperative Genitourinary Challenges in Children with Anorectal Malformations: A Prospective Cohort Study

Fatemeh Abedi Karjiban1, Fariba Jahangiri2, Mahmoud Salek2

  • 1School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Medical Journal of the Islamic Republic of Iran
|July 28, 2026
PubMed

Insights

Anorectal malformations (ARM) are linked to neurogenic bladder and vesicoureteral reflux (VUR), particularly with posterior sagittal anorectoplasty (PSARP) and high-type ARM. Early diagnosis and follow-up are vital to prevent kidney failure.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Congenital Anomalies

Background:

  • Anorectal malformations (ARM) are congenital defects often accompanied by genitourinary (GU) issues.
  • Surgical interventions for ARM include colostomy and posterior sagittal anorectoplasty (PSARP).

Purpose of the Study:

  • To assess the incidence of neurogenic bladder and vesicoureteral reflux (VUR) in pediatric patients with ARM.
  • To explore associations between these GU abnormalities and ARM type, fistula location, vertebral anomalies, and surgical techniques.

Main Methods:

  • A retrospective cohort study of 173 children with ARM was conducted over a 10-year period (July 2011-July 2021).
  • Genitourinary data, including urinary tract infections, VUR, and neurogenic bladder, were collected from medical records and follow-up visits.

Main Results:

  • Neurogenic bladder (37 patients) and VUR (44 patients) were diagnosed in a significant portion of the cohort.
  • Higher rates of neurogenic bladder and VUR were observed in patients undergoing PSARP.
  • Neurogenic bladder was more common in high-type ARM and rectourethral fistula cases, with recurrent UTIs highest in boys with high-type ARM.
  • Approximately 8% of patients developed signs of kidney failure.

Conclusions:

  • Genitourinary issues are common in ARM patients, necessitating parental education on regular follow-up.
  • Early detection and intervention are critical to prevent long-term kidney damage and progression to end-stage renal disease (ESRD).
Abstract

Keywords:
Anorectal MalformationNeurogenic BladderPostoperative ComplicationsUrinary Tract InfectionVesicoureteral Reflux

Related Concept Videos

Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
Microbiota of the Urogenital Tract01:28

Microbiota of the Urogenital Tract

The human urogenital system, once thought to be sterile in healthy individuals, is now recognized as a complex microbial habitat. Advancements in molecular sequencing techniques have revealed that even in healthy adults, the kidneys and bladder harbor microbial populations similar to those found in the distal urethra, albeit in much lower abundance. These resident microorganisms, while generally innocuous, can become opportunistic pathogens under conditions that alter the urogenital...
Anatomy of the Genitourinary System II: Bladder and Urethra01:19

Anatomy of the Genitourinary System II: Bladder and Urethra

The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...