The increased occurrence of genitourinary tract anomalies in infants with imperforate anus is well documented.
A retrospective analysis was made on 130 children with imperforate anus over the last 10 years. A 21% (27 cases) incidence of associated genitourinary anormalies was found in this series. Patients with high and intermediate imperforate anus
domonstrated
a 30% (19/64) incidece of genitourinary anomalies. In contrast; patients with low imperforate anus revealed 12% (8/66) incidence of genitourinary anomalies. The spectrum of these anomalies were hydronephrosis, bilateral ranal agenesis, bilateral
polycystic kidney, bilateral VUR, unilateral renal hypoplasia, posterior urethral stricuture, renal stone, cryptorchidism, hypospadias and epispadias in descending frequency of order. Hydronephrosis (13/27, 48%) was the most frequently
encountered
anomaly. Patients with high imperforate anus seems to be prone to have more severe urinary anomalies. Fistulae between the rectum and urinary tract were found in 33 patients with high and intermediate type imperforate anus (rectourethral fistula;
27
cases, rectovesical fistula; 3 cases, rectoclocloacal fistula: 3 cases). During the posterior sagittal anorectoplasty, fistula was corrected simultaneously.
In conclusion, early urological screening should be done for the early diagnosis and treatment of associated genitourinary anomalies in all children with imperforate anus.
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