Evaluation of the functional outcome of the neonatal one stage posterior sagittal anorectoplasty (PSARP) as a procedure to treat cases of high anorectal malformation in male neonates

Background: The management of anorectal malformations universally uses posterior sagittal anorectoplasty (PSARP) as standard surgery. The aim of this research was to determine continence in patients with anorectal malformation after PSARP action.Methods: This study was a descriptive analytical categorical research with cross sectional design. The data were obtained from patients’ medical records and questionnaire given to patients underwent PSARP in Wahidin Sudirohusodo Hospital and network hospitals from June 1 to December 1, 2018. The analysis was done to 60 children ranging from 5 to 8 years old. Most of them were male (56.7%) ranging from 5 to 6 years old (53.3%).Results: The results of the research indicated that based on malformation subtype, most of them suffered from rectourethra fistula (40.0%) with continence problem (61.7%). There was no significant correlation between sex and continence problem (p >0.05). However, it was seen that the percentage of continence subjects was higher in female (65.4%) than in male (58.8%), while the percentage of soiling and constipated subjects was higher in male than in female. Rectourethra fistula was found more frequently in male than in female (70.6%), while vestibuler fistula was found more frequently in female (69.2%). There was no significant correlation between age and defecation problem (p >0.05). However, the percentage of continence and soiling subjects was higher in 5-6 years children then the one for 7-8 year children, while the percentage of constipated subjects was higher in 7-8 year children (21.4%) than 5-8 year children (18.8%).Conclusions: Gender differences in the outcome of children with anorectal malformations must be considered. Men with perineal fistula were likely to experience continence and constipation than women with perineal fistulas. Women with perineal fistulas and vestibular fistulas had almost similar outcome.

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COMPARISON OF CLINICAL OUTCOMES IN PATIENTS WITH CONGENITAL ANORECTAL MALFORMATION TREATED WITH POSTERIOR SAGITTAL ANORECTOPLASTY AND LAPAROSCOPICALLY ASSISTED ANORECTAL PULL THROUGH

Indian Journal of Child Health ◽

10.32677/ijch.2016.v03.i04.015 ◽

2016 ◽

Vol 03 (04) ◽

pp. 330-334

Author(s):

Vijaymahantesh S Kunnur ◽

Chandra Shekhar Singh ◽

Shanthala V Kunnur ◽

Anil Kumar S Kunnur

Keyword(s):

Clinical Outcomes ◽

Anorectal Malformation ◽

Posterior Sagittal Anorectoplasty ◽

Pull Through

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Anatomical and functional outcome after bilateral scrotal flap in penile reconstruction

Asian Biomedicine ◽

10.5372/1905-7415.0801.265 ◽

2014 ◽

Vol 8 (1) ◽

pp. 83-86 ◽

Cited By ~ 3

Author(s):

Pornthep Pungrasmi ◽

Anon Chayasadom ◽

Apichai Angspatt

Keyword(s):

Foreign Body ◽

Sexual Activity ◽

Functional Outcome ◽

Surgical Excision ◽

Foreign Body Granuloma ◽

Surgical Removal ◽

Penile Skin ◽

One Stage ◽

Before And After ◽

The Mean

Abstract Background: Injection of alloplastic material underneath the penile skin for penile augmentation causes many complications such as inflammation, infection, ulceration, and pain during sexual activity. One of the treatments for complications after these penile augmentation procedures is surgical excision of the foreign body granuloma followed by penile skin coverage with bilateral scrotal flaps. There are no prior prospective studies published about anatomical and functional outcomes. Objective: To study the anatomical and functional outcome of one-stage bilateral scrotal flap reconstruction in patients after surgical removal of paraffinoma from penile shafts. Methods: Patients who suffered from complications of penile foreign body granuloma were treated by surgical excision and reconstruction with bilateral scrotal flaps. The penile lengths and circumferences when flaccid and erect were recorded preoperatively and postoperatively. The patients were interviewed using questionnaires and satisfaction scored to determine their sexual experiences were recorded before and after surgery. Results: Thirteen patients were enrolled in this study. The mean follow-up time was 23.5 (11.5-40.5) weeks. The mean erectile length and the maximal circumference were 11.8 (9-15) cm, 14.5 (11.5-17) cm preoperatively, and 11.7 (10-14) cm, 11.8 (10-13) cm postoperatively. Satisfaction scores of sexual activity is 6.84 (0-9) preoperatively, and 8.38 (5-10) postoperatively. Conclusion: One-stage bilateral scrotal flap coverage is a good option for penile skin reconstruction. This technique can achieve satisfactory results both anatomically and functionally.

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Fecal Incontinence after Posterior Sagittal Anorectoplasty for Anorectal Malformation: A Single-Center Study

Scientifica ◽

10.1155/2018/8297617 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Manoochehr Ghorbanpoor ◽

Behzad Dehvan ◽

Siavash Rahimi ◽

Azar Pirdehghan

Keyword(s):

Fecal Incontinence ◽

Anorectal Malformation ◽

Fecal Continence ◽

Posterior Sagittal Anorectoplasty ◽

Medical Sciences ◽

High Type ◽

Single Center Study ◽

The Status ◽

The Difference

Background. Fecal incontinence is one of the worst functional complications of posterior sagittal anorectoplasty for treatment of anorectal malformation. Objectives. In this study, we aimed to identify the prevalence of fecal incontinence in patients with the diagnosis of high or low anorectal malformation who underwent three-stage posterior sagittal anorectoplasty surgery in our center. Patients and Methods. Children with the diagnosis of anorectal malformation who underwent posterior sagittal anorectoplasty at the Department of Pediatric Surgery of Besat Hospital, Hamadan University of Medical Sciences, Iran, from 2012 to 2016 were enrolled in the study. Parents or guardians were recruited and asked to fill the study questionnaire including the Templeton and Ditesheim Scoring System to assess the status of fecal continence of the patients. Results. Thirty-four patients including 10 (29.4%) males were enrolled in the study. High type of anorectal malformation was diagnosed in 23 (67.6%) patients. The overall mean scores of fecal continence were 4.57 ± 0.84 (range 1.5–5) after a mean follow-up time of 50.7 (range 22.5–69.8) months. Good fecal continence was observed in 91.3% of patients with low type compared to 72.8% of patients with high type of anorectal malformation; however, the difference was not significant (P=0.13). Conclusion. Posterior sagittal anorectoplasty surgery in patients with anorectal malformation may result in acceptable fecal continence.

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Anorectal malformation with long perineal fistula: one of a special type

Scientific Reports ◽

10.1038/s41598-021-81056-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sen Li ◽

Jun Wang

Keyword(s):

Anorectal Malformation ◽

Bowel Function ◽

Anorectal Malformations ◽

Contrast Enema ◽

Posterior Sagittal Anorectoplasty ◽

Function Score ◽

Perineal Fistula ◽

Definitive Surgery ◽

Inhibitory Reflex

AbstractThe anorectal malformation with long perineal fistula is a rare anomaly in the spectrum of anorectal malformations. Aim of the study is to describe the series of patients with anorectal malformation with long perineal fistula and compare the outcome with patient with standard perineal fistula. From March 2012 to January 2019, 7 patients who suffered from anorectal malformation with long perineal fistula were retrospectively reviewed. Three were operated on primarily by our department, and 4 cases were re-operated after a perineal anoplasty repair performed elsewhere. Four were operated by laparoscopy assisted anorectoplasty, and 3 cases were repaired by posterior sagittal anorectoplasty. The follow-up outcomes were compared with 71 cases of normal perineal fistula (NPF) in the same period. 7 cases have been followed up for 0.5–4 years (M = 2.57 ± 1.26) after definitive surgery. Their bowel function score was lower than normal perineal fistula (SPF = 12, range: 5–18; NPF = 18.5, range: 18–20). Four cases underwent anorectomanometry. The incidence of rectoanal inhibitory reflex was lower in the special type group. (p = 0.14). Three cases of contrast enema using barium: 2 cases of colorectal dilatation and thickening changes, 1 case showed no obvious abnormalities. Anorectal perineal fistula should be examined by distal colostogram at preoperation. This should be altered in: When suspecting a case of anorectal malformation type long perineal fistula a preoperative contrast enema could give insight of the anatomy befor performing a anoplasty.

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