Urologic anomalies associated with anorectal malformation(Advances in Reconstructive Surgery of the Urinary Tract)

Treatment of the urologic anomalies associate with anorectal malformation and recent operative methods for the imperforate anus were discussed. Thirty six patients of major urologic anomalies were found in 228 patients of imperforate anus. Urologic anomalies were undescended testis in 12 cases, hypospadia in 8, phymosis in 3, renal dysplasia in 6, hydroureter in 6, vesicoureteric reflux (VUR) in 12 and so on. Imperforate anus associate urologic anomalies had high rate abnormalities of sacrum or vertebra. Orchiopexy was done in 8 patients from 8 months to 9 years old. Hypospadia were operated in 2 patients at 4 years old. Nephrectomy was performed for unilateral dysgenesis of the kidney with hydroureter in 3 patients from 2 months to 6 years old. Antireflux operation was done for the VUR in 3 patients from 3 to 6 years old. VUR disappeared after the anoplasty in 5 patients under 2 years old. Operative methods and diagnostic procedures were discussed for imperforated anus with urologic anomalies. Sacroperineal anoplasty were perfomed in intermediate type or occasional high type anorectal malformations recently. Vesicointestinal fissure was most severe anomaly in the case of imperforated anus with urologic anomalies. Treatment of this anomaly shuold be done uunder the team arranged by each special doctor including pediatric surgeon, urologist, and orthopedist