Anorectal malformations: Definitive management during and beyond adolescence

Abstract

Aim:To evaluate our results of definitive repair of anorectal malformations in patients with delayed presentation, during and beyond adolescence.Material and Methods:It is a retrospective analysis of all adolescent patients presenting for the first time for definitive repairs and innate patients - colostomy performed during the neonatal period, but who had lost to follow-up. It includes 15 patients (2 male and 13 female) aged from 13 to 32 years. Three well-decompressed female patients were managed by primary anterior sagittal anorectoplasty (ASARP). Twelve patients underwent staged procedures. Five patients (two male and three female) underwent posterior sagittal anorectoplasty (PSARP). The oldest male patient underwent abdominal-PSARP.Results:All of them attained socially acceptable fecal continence at follow-up of 1–4½ years. They are satisfied with the functional and cosmetic outcome of repair of their anomalies.Conclusions:Prospects of fecal continence are good when definitive repair of anorectal malformations is done by an expert, even in the adolescent age group and beyond.

Anorectal malformations in adolescent females: A retrospective study

“…The cosmetic outcome as assessed by the appearance of perineum and calibration of neoanus was near satisfactory in all. Although the cosmetic outcome is reported to be the superior in ASARP,[ 2 8 9 ] we did not find much difference between the two procedures in our series. The two girls with wound dehiscence had an acceptable perineum following anoplasty.…”

“…In one study, adolescent ARMs comprised around 15%–20% ARM cases. [ 2 ] Management of these cases is challenging as they are uncommon, sparingly reported in literature, and there is a lack of information in available literature regarding their management and outcome. In this study, we describe the presentation, management, and outcome of adolescent females presenting with ARM.…”

Female anorectal malformation in a woman

“…Delayed presentation is common in developing countries; however, delaying the treatment up to the age of 28 years is uncommon. Delayed diagnosis may be attributed to lack of knowledge, awareness, poverty and poor care offered to girl children in some parts of this country 5 6. Besides, sometimes, wrong advice regarding the correct age of treatment also leads to delay in treatment.…”

Anorectal Malformation: Presentation Beyond Adolescence

“…Degree of continence can vary from diarrhea to constipation. Studies have shown that 60% have good continence, 24% have minor aberrations in anal function like occasional and/or slight smearing and 13% have difficulties in sexual function after reconstructive surgery [3].…”