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Posterior sagittal approach for repair of rectourethral fistula occurring after perineal surgery for imperforated anus at birth.
J Pediatr Surg. 2000 Aug; 35(8):1155-60.JP

Abstract

PURPOSE

Posterior sagittal approach was used for the repair of 11 cases of rectourethral fistula between 1992 and 1998.

METHODS

All these patients had rectourethral fistula as a result of perineal procedure performed for imperforate anus at the time of birth. In addition to the fistula repair, an associated anorectal stenosis (3 cases) and urethral stricture 11 case) also were corrected with this approach. All the patients underwent surgery under cover of a protective colostomy.

RESULTS

Successful repair was achieved in all patients, and the follow-up period ranged from 10 months to 7 years. As far as bladder and bowel control, urinary control was normal in all 11 patients, whereas bowel control was normal in 10 cases. One patient who had severe scarring of anal sphincters caused by infection in the previous surgery still suffers occasional perianal soiling after 18 months of follow-up.

CONCLUSIONS

Posterior sagittal approach not only gives adequate exposure but also suits the basic principles of fistula repair, namely, completely separating the rectum from urethra and leaving normal rectal wall behind the urethral sutures thus eliminating the possibility of recurrence. In addition to fistula repair, one can also correct associated problems like anorectal stenosis or urethral stricture, and a mislocated rectum can be relocated within the sphincter complex.

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Publisher Full Text

Authors+Show Affiliations

Kulshrestha S
Division of Pediatric Surgery, Sarkar Hospital for Women & Children, Agra, India.
Kulshrestha M
No affiliation info available
Yadav A
No affiliation info available
Singh B
No affiliation info available
Elhence IP
No affiliation info available
Gangopadhyay AN
No affiliation info available
Sarkar B
No affiliation info available
Tewari V
No affiliation info available

MeSH

AdultAnus, ImperforateChildChild, PreschoolColostomyFollow-Up StudiesHumansInfantMalePerineumPostoperative ComplicationsRectal FistulaTime FactorsUrethral DiseasesUrinary Fistula

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10945685

Citation

Kulshrestha, S, et al. "Posterior Sagittal Approach for Repair of Rectourethral Fistula Occurring After Perineal Surgery for Imperforated Anus at Birth." Journal of Pediatric Surgery, vol. 35, no. 8, 2000, pp. 1155-60.
Kulshrestha S, Kulshrestha M, Yadav A, et al. Posterior sagittal approach for repair of rectourethral fistula occurring after perineal surgery for imperforated anus at birth. J Pediatr Surg. 2000;35(8):1155-60.
Kulshrestha, S., Kulshrestha, M., Yadav, A., Singh, B., Elhence, I. P., Gangopadhyay, A. N., Sarkar, B., & Tewari, V. (2000). Posterior sagittal approach for repair of rectourethral fistula occurring after perineal surgery for imperforated anus at birth. Journal of Pediatric Surgery, 35(8), 1155-60.
Kulshrestha S, et al. Posterior Sagittal Approach for Repair of Rectourethral Fistula Occurring After Perineal Surgery for Imperforated Anus at Birth. J Pediatr Surg. 2000;35(8):1155-60. PubMed PMID: 10945685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posterior sagittal approach for repair of rectourethral fistula occurring after perineal surgery for imperforated anus at birth. AU - Kulshrestha,S, AU - Kulshrestha,M, AU - Yadav,A, AU - Singh,B, AU - Elhence,I P, AU - Gangopadhyay,A N, AU - Sarkar,B, AU - Tewari,V, PY - 2000/8/17/pubmed PY - 2001/2/28/medline PY - 2000/8/17/entrez SP - 1155 EP - 60 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 35 IS - 8 N2 - PURPOSE: Posterior sagittal approach was used for the repair of 11 cases of rectourethral fistula between 1992 and 1998. METHODS: All these patients had rectourethral fistula as a result of perineal procedure performed for imperforate anus at the time of birth. In addition to the fistula repair, an associated anorectal stenosis (3 cases) and urethral stricture 11 case) also were corrected with this approach. All the patients underwent surgery under cover of a protective colostomy. RESULTS: Successful repair was achieved in all patients, and the follow-up period ranged from 10 months to 7 years. As far as bladder and bowel control, urinary control was normal in all 11 patients, whereas bowel control was normal in 10 cases. One patient who had severe scarring of anal sphincters caused by infection in the previous surgery still suffers occasional perianal soiling after 18 months of follow-up. CONCLUSIONS: Posterior sagittal approach not only gives adequate exposure but also suits the basic principles of fistula repair, namely, completely separating the rectum from urethra and leaving normal rectal wall behind the urethral sutures thus eliminating the possibility of recurrence. In addition to fistula repair, one can also correct associated problems like anorectal stenosis or urethral stricture, and a mislocated rectum can be relocated within the sphincter complex. SN - 0022-3468 UR - https://www.unboundmedicine.com/medline/citation/10945685/Posterior_sagittal_approach_for_repair_of_rectourethral_fistula_occurring_after_perineal_surgery_for_imperforated_anus_at_birth_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(00)54735-6 DB - PRIME DP - Unbound Medicine ER -