Title

A call to ARMs: Accurate identification of the anatomy of the rectourethral fistula in anorectal malformations

Document Type

Journal Article

Publication Date

8-1-2019

Journal

Journal of Pediatric Surgery

Volume

54

Issue

8

DOI

10.1016/j.jpedsurg.2019.04.010

Keywords

Anorectal malformation; Distal colostogram; Fecal continence; Imperforate anus; Rectourethral fistula; Urethral fistula

Abstract

© 2019 Elsevier Inc. Recto-urethral fistulae are the most common finding in males born with an anorectal malformation (ARM). A high pressure distal colostogram is an important tool in visualizing the fistula, although the precise level at which the fistula communicates with the urethra may be difficult to interpret and is not reported in a uniform manner. This anatomy affects the surgical plan; determining the likelihood that the rectum is reachable via a posterior sagittal incision or better approached through the abdomen via laparoscopy or laparotomy helps counsel families and stratifies diagnoses for outcomes work. Herein we present a figure used at our Center to assist with correlating findings on the distal colostogram with the anatomic level of the recto-urethral fistula in males with anorectal malformations.

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