Lower urinary tract dysfunction in cases of anorectal malformations

Abstract

Association of genitourinary anomalies in patients with ano-rectal malformations (ARM) is well known and its incidence is reported to be 30 -50%. Many of these anomalies either have less number of functioning renal units or have conditions with risk of continuous damage to renal units, increasing the risk of developing End stage renal disease (ESRD) in adolescence or adulthood. Although frequently described as associated malformations but few of these entities like Vesico ureteric reflux (VUR) could be the result of lower urinary tract dysfunctions.: To study incidence and spectrum of Lower urinary tract dysfunction in toilet trained patients of ARM. To find whether LUTD is the cause of worsening of VUR/HUN/ renal functions in patients with ARM. 2 years (October 2018 to 30 September 2020): Department of Paediatric surgery, Chacha Nehru Bal Chikitsalaya, Geeta Colony Delhi Prospective observational study. : Forty-two patients of ARM, meeting all inclusion criteria were enrolled in the study. All the following criteria were checked for enrolment of patient in the study. 1. Patients of all categories of anorectal malformations who were toilet trained; 2. Age more than 4 years; 3. Completed set of investigations planned for diagnosis of LUTD. 4. Consented to participate in the study and for follow up as and when required.Central cause of neurological deficits.A total of 125 patients who underwent PSARP during our study period. However only 42 patients met the inclusion criteria and got their work up completed for urological problems. 1.LUTD and renal failure can be seen even in absence of spinal malformations in patients with ARM; 2. Severity of LUTD in absence of neurological involvement changes with time; 3. Thorough history and clinical evaluation may provide important clues in suspecting presence of occult LUTD.