Urologic implications of imperforate anus.

ABSTRACT

Recent clinical studies have documented the high association of genitourinary and lumbosacral spine anomalies with imperforate anus. Many of these associated anomalies may go undetected unless special diagnostic studies are performed, and these genitourinary anomalies can be the cause of significant clinical morbidity in later life if not managed properly initially. All neonates with imperforate anus should therefore undergo radiographic examination with lower spine films, intravenous pyelography and voiding cystourethrography, and cystoscopy should be reserved for those with cloaca deformity or those whose x-ray films demonstrate urinary anomalies requiring further workup. Significant morbidity involving the genitourinary tract may be encountered after surgical treatment of the anorectal anomaly, particularly if total anorectal reconstructions are performed in the neonatal period.