German network for congenital uro-rectal malformations: first evaluation and interpretation of postoperative urological complications in anorectal malformations.

Abstract

OBJECTIVE:

The aim of the German Network for Congenital Uro-REctal Malformations is to collect data of affected patients with anorectal malformation (ARM) or extrophy-epispadias complex, and to investigate molecular causes, clinical implications, and psychosocial outcome. The current issue was to assess the postoperative sequelae related to lower urinary tract dysfunction in patients with ARM.

MATERIALS AND METHODS:

Two hundred and sixty-seven patients with ARM (112 females, 155 males, median age 6 years, range 0-56 years) were investigated via standardized case report forms comprising interview, analysis of medical data, and personal questionnaires.

RESULTS:

Thirty-two patients (12%, 23 males, 9 females) suffered from neurogenic bladder dysfunction, mainly associated with recto-urethral fistula (11 cases, 34%), and recto-vesical fistula (6 cases, 19%). Sixty-eight patients (26%, 35 males, 57 females) have experienced lifetime urinary tract infection, primarily associated with recto-urethral fistula (21 cases, 31%), and vestibular fistula (13 cases, 19%). According to type of operation, the highest number of postoperative urologic problems was reported after abdominosacroperineal pull-through.

CONCLUSION:

Besides reconstructing the ARM, another main goal is the preservation of lower urinary tract function. In our data, there seems to be a close correlation between operative strategies and postoperative complications.

• Authors: Stefanie Maerzheuser, Ekkehart Jenetzky, Nadine Zwink, Heiko Reutter, Enrika Bartels, Sabine Grasshoff-Derr, Stefan Holland-Cunz, Stuart Hosie, Eberhard Schmiedeke, Nicole Schwarzer, Nicole Spychalski, Gabriel Goetz, Dominik Schmidt
• Journal: Pediatric surgery international (Pediatr Surg Int) Vol. 27 Issue 10 Pg. 1085-9 (Oct 2011) ISSN: 1437-9813 [Electronic] Germany
• PMID: 21792651 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Anal Canal (abnormalities)
• Child
• Child, Preschool
• Chronic Disease
• Digestive System Abnormalities (surgery)
• Female
• Germany (epidemiology)
• Humans
• Infant
• Infant, Newborn
• Male
• Middle Aged
• Postoperative Complications (epidemiology, etiology, surgery)
• Rectal Fistula (epidemiology, etiology, surgery)
• Rectum (abnormalities)
• Urethral Diseases (epidemiology, etiology, surgery)
• Urinary Bladder, Neurogenic (epidemiology, etiology, surgery)
• Urinary Fistula (epidemiology, etiology, surgery)
• Urinary Tract Infections (epidemiology, etiology, surgery)
• Urologic Diseases (epidemiology, etiology, surgery)