Urogenital Tract Abnormalities Associated with Esophageal Atresia and Tracheoesophageal Fistula

Abstract

The medical records were reviewed of 127 consecutive patients with esophageal atresia alone and with tracheoesophageal fistula. Systematical genitourinary tract examination in 112 patients showed anomalies in 24 (21.4 per cent). A survey of the literature on this subject is given. Of 8 patients with the VATER association renal involvement was found in 6. The results of urinary tract imaging by excretory urography and ultrasonography are compared to each other. Prompt and appropriate genitourinary tract examination by physical examination, urinalysis, serum creatinine levels and ultrasonography or excretory urography is recommended as a standard in all children with esophageal atresia, with further investigations ordered if indicated by the results of the studies.

Urethral abnormalities in male neonates with VATER association.

“…The association between both upper and lower gastrointestinal malformations and genitourinary anomalies has been investigated and reported [2][3][4][5][6][7]. Upper urinary tract abnormalities are more common with supralevator imperforate anus than with infralevator imperforate anus [5].…”

“…In the literature on the VATER association, only a few urethral abnormalities, such as hypospadias and chordee, have been described [2][3][4][5][6]. None of the prior papers has stressed the increased occurrence of urethral anomalies in the VATER association, and none has specifically looked at the prognosis of infants with imperforate anus and megabourethra.…”

Modern Paediatric Urology*

“…Finally, they have to accept the possibility of a new diversion in case of failure of the undiversion (Scholtmeijer, 1984). Anorectal malformations and oesophageal atresia are frequently associated with urological disorders (Hoekstra et al, 1983;Berkhoff et al, 1989) and only close co-operation between the paediatric surgeon and paediatric urologist will provide the best opportunity for a good quality of life for many patients. Apart from rectourethral and rectovaginal fistulae, anomalies of the urogenital tract are found in 50% of patients with anorectal malformations (Hoekstra et al, 1983).…”