Urogenital Tract Abnormalities Associated with Congenital Anorectal Malformations

Abstract

Objective: Genitourinary anomalies in patients with imperforate anus are a frequent source of significant morbidity. Variability of reports on the incidence of associated anomalies with imperforate anus mandates investigation on this issue.

Material & Methods: The case records and imaging studies of 105 patients who underwent surgery for imperforate anus over a 10-year period are retrospectively reviewed. Voiding cystouretherography, intra venous pyelography (IVP) and ultrasound were performed in  patients with intermediate or high level anorectal lesions.

Findings: During 10 years, there were 48 boys (45.7%) and 57 girls (54.3%) with imperforate anus. Genitourinary anomalies were seen in 34 (48.6%) patients with intermediate or high level anorectal lesions. Eighteen of them (52.9%) were shown to have vesicouretral reflux, only 6 of them required surgical correction. Vesicoureteral reflux was the most prominent urologic anomaly; other anomalies such as ureteropelvic junction (UPJ) stenosis, hydronephrosis, hypospadias, renal agenesis and undescended testis were seen in these series.

Conclusion: Patients with anorectal malformations should be evaluated for urinary tract and spinal anomalies.