Abstract
BackgroundRecto-perineal fistula is a common anorectal anomaly, affecting both males and females. The anus is abnormally anteriorly located and is usually stenotic. Management of recto-perineal fistula is a dialectic problem. The most common presenting complaint is constipation; also, long-term follow-up of these patients revealed high incidence of postoperative constipation.ResultsThe study included 30 patients (19 female and 11 male). Their age at time of repair ranged from 3 to 78 months. We compared the pre- and postoperative constipation rate after limited posterior sagittal anorectoplasty (PSARP) using Krickenbeck score. Overall, the rate of constipation has dropped from 77 (23/30) to 30% (9/30) after surgery. Fourteen patients out of 23 patients with preoperative constipation were cured. Another patient with preoperative constipation improved regarding the grade of constipation. The remaining 8 patients with preoperative constipation did not show improvement after operation. These results were statistically significant (McNemar test). Out of the 9 patients who were still constipated after surgery, 7 had associated fecal soiling that showed good response with bowel management of constipation.ConclusionLimited posterior sagittal anorectoplasty can have a role in treating constipation among cases of recto-perineal fistula.
Highlights
IntroductionThe most common presenting complaint is constipation; long-term follow-up of these patients revealed high incidence of postoperative constipation
Recto-perineal fistula is a common anorectal anomaly, affecting both males and females
Limited posterior sagittal anorectoplasty (PSARP) is the most common surgical technique used for the repair of recto-perineal fistula [2]
Summary
The most common presenting complaint is constipation; long-term follow-up of these patients revealed high incidence of postoperative constipation. Recto-perineal fistula is a common anorectal anomaly, affecting both males and females [1]. Limited posterior sagittal anorectoplasty (PSARP) is the most common surgical technique used for the repair of recto-perineal fistula [2]. The functional outcomes after the repair of recto-perineal fistula have been considered by some authors as satisfactory. Long-term follow-up of these patients revealed high incidence of postoperative constipation [3,4,5]. Our aim was to study the effect of surgery (limited PSARP) on constipation among patients May constipation persist after surgery, and some scholars suggested that it may even get worse [6].
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