Anal Stenosis Research Articles

Laser hemorrhoidoplasty versus hemorrhoidectomy in the treatment of surgically indicated hemorrhoids in inflammatory bowel patients: a randomized comparative clinical study.

This study aims to assess and compare the outcomes of traditional surgery and laser surgery for anal hemorrhoids in patients with inflammatory bowel disease. This is a single-center prospective randomized comparative clinical trial performed at Zagazig University Hospitals from September 2023 to September 2024. The study comprised 48 patients who were admitted during this period and had inflammatory bowel disease along with hemorrhoids. The patients were randomly allocated into two groups: Group I consisted of 24 patients who underwent laser hemorrhoidoplasty, selected based on odd numbers, while Group II consisted of 24 patients who underwent traditional surgery, selected based on even numbers. Group I, which underwent laser treatment for hemorrhoids in inflammatory bowel patients, demonstrated significantly better outcomes than traditional surgery (p < 0.001) regarding operation time, pain score and duration, postoperative anal discharge, return to work time, and patient satisfaction. Moreover, laser treatment was found to be more effective than traditional surgery for treating hemorrhoids in inflammatory bowel patients in terms of postoperative bleeding and anal stenosis. Additionally, there was a higher frequency of residual hemorrhoids in laser group. Laser treatment is mostly superior to traditional surgery for hemorrhoids in inflammatory bowel patients. Clinical Trial.gov (NCT06216223), registered on December 27, 2023, last updated in May 12, 2024. PROTOCOL REGISTRATION ID: #101080-5-9-2023.

Safety and Efficacy of Endoscopic Submucosal Dissection for Rectal Neoplasms Extending to the Dentate Line: A Systematic Review and Meta-analysis.

Endoscopic submucosal dissection (ESD) is a superior, minimally invasive technique compared with other snare-based endoscopic resection techniques for rectal neoplasms extending to the dentate line (RNDLs). However, performing a successful ESD in the anal canal can be challenging due to vascularity and limited scope stability. In this meta-analysis, we aim to evaluate the safety and efficacy of ESD for RNDLs. We performed a comprehensive electronic database search from January 2005 through January 2024 for studies evaluating outcomes of ESD performed for managing RNDLs. Pooled proportions were calculated using random-effect models. Heterogeneity was evaluated using I2 and Q statistics. Data were extracted from 11 studies comprising 496 patients. The pooled en bloc resection rates were 93.60% (95% CI = 90.70-95.70). The pooled R0 resection rate was 80.60% (95% CI = 70.50-87.80). The pooled recurrence rate was 4.00% (95% CI = 2.40-6.50). There was no evidence of significant heterogeneity calculated using the Q test and I2 statistic. The main adverse events were anal pain, postprocedural bleeding, and anal stricture with pooled rates of 20.20% (95% CI = 14.80-26.90), 8.20% (95% CI = 4.70-14.0), and 3.50% (95% CI = 2.10-5.70), respectively. ESD is a safe and effective option for managing RNDLs with a low recurrence rate. Adverse events such as postprocedural perianal pain, postprocedural bleeding, and anal stenosis seem to be more common compared with colorectal ESD done for more proximal lesions. However, these can typically be managed conservatively or with minimally invasive endoscopic techniques.

One stage anterior sagittal sphincter saving anorectoplasty (ASSSARP) for the repair or rectovestibular fistula: mid and long-term outcome in two tertiary centers

PurposeThis is a retrospective study of one-stage anterior sagittal sphincter saving anorectoplasty (ASSSARP) for repairing rectovestibular fistula (RVF) including operative details and postoperative complications, functional and cosmetic outcome.Patients and methodsRecords of 41 cases of RVF, managed between April 2010 and September 2019 by one-stage ASSSARP, were reviewed. Preoperative preparation, both early and late postoperative care & complications, hospital stay, and functional & cosmetic outcomes were reported.ResultsThe mean age was 6.6 months. Vaginal tear occurred in 5/41 cases, and distal rectal tears in 4/41 cases. Thirteen patients suffered mild superficial wound inflammation; while Skin dehiscence; occurred in five patients. No colostomy or redo was needed. The mean hospital stay was 6.1 days. Mean follow-up was 43.13 months; (Range; 24–100 months). Subclinical anal stricture was detected in six patients. Constipation occurred in 14 cases. Soiling grade I occurred in five patients. Thirty-two patients reached past the age of three years; two of whom showed cough/diarrhea incontinence.ConclusionOne-stage ASSSARP is safe and gives functional and cosmetic results comparable to other techniques. It provides better access during RVF repair. The avoidance of muscle incision protects against muscle breakdown, if infection sets in, and thus against incontinence. It avoids the morbidity, cost and psychological burden of performing a three-stage repair.

Diagnosis and Management of Anal Stenosis.

Diagnosis and Management of Anal Stenosis.

Expert Commentary on Diagnosis and Management of Anal Stenosis

Expert Commentary on Diagnosis and Management of Anal Stenosis

A Comparative Study between Early and Late Correction of Cases of Anorectal Malformation, Assessed by Fecal and Urinary Functional Outcome

Abstract Background Anorectal malformation (ARM) includes a wide spectrum of anomalies of the anorectal and urogenital region. They are not rarely associated with orthopedic, spinal, and neurologic abnormalities effecting the short- and long-term outcome. anorectoplasty at an early age is important for obtaining a better life quality in ARM patients. Aim Aim of the work to study defecation and urinary functional outcome according to timing of correction of ARM. Patients and Methods This was a cross sectional study conducted at patients with anorectal malformations (perineal fistula, rectourethral fistula, rectovesical fistula, vestibular fistula, no fistula, anal stenosis), at the Ain Shams pediatric surgery department and Qena pediatric surgery unit. Results bowel function and quality of life were significantly higher in early correction group compared to late correction group(p &amp;lt; 0.001). The mean of the quality of life in the early and late correction groups was 12.83± 0.59 and 11.13± 2.73 respectively. Conclusion Early anorectoplasty and early appropriate bowel management is advisable, as that is essential for less fecal and urinary functional complications, and for proper life quality.

Modified stapled hemorrhoidopexy for lower postoperative stenosis: A five-year experience.

Stapled hemorrhoidopexy (SH) is currently a widely accepted method for treating the prolapse of internal hemorrhoids. Postoperative anal stenosis is a critical complication of SH. A remedy for this involves the removal of the circumferential staples of the anastomosis, followed by the creation of a hand-sewn anastomosis. Numerous studies have reported modified SH procedures to improve outcomes. We hypothesized that our modified SH technique may help reduce complications of anal stenosis after SH. To compare outcomes of staple removal at the 3- and 9-o'clock positions during modified SH in patients with mixed hemorrhoids. This was a single-center, retrospective, observational study. Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1, 2015, and January 1, 2020, were included. The operation time, blood loss, length of hospital stay, and incidence of minor or major complications were recorded. Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1, 2015 and January 1, 2020, were included. Operation time, blood loss, length of hospital stay, and incidence of minor or major complications were recorded. We investigated 187 patients (mean age, 50.9 years) who had undergone our modified SH and 313 patients (mean age, 53.0 years) who had undergone standard SH. In the modified SH group, 54% of patients had previously undergone surgical intervention for hemorrhoids, compared with the 40.3% of patients in the standard SH group. The modified SH group included five (2.7%) patients with anal stenosis, while 21 (6.7%) patients in the standard SH group had complications of anal stenosis. There was a significant relationship between the rate of postoperative anal stenosis and the modified SH: 0.251 (0.085-0.741) and 0.211 (0.069-0.641) in multiple regression analysis. The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH. The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH.

Primary Anterior Sagittal Anorectoplasty Shift from Staged to Single-stage Procedure for Low Anorectal Malformations in Female Children: Our Initial Experience in Single Centre.

Anorectal malformation (ARM) is a common congenital anomaly found in the paediatric age group. Previously, the repair of the vestibular fistula (VF) was performed as three-stage procedure with initial colostomy followed by a definite procedure and, lastly, colostomy closure. At present, a single-stage procedure is preferred, especially in lower anomalies owing to the convenient and time-saving approach. The clinical profile and outcome of ASARP for treatment of ARM in females (vestibular anus and perineal fistula). A retrospective analytical study was conducted at Government Medical College, Jammu. A total of 60 patients were included in the study. Most of the patients were in the age group of 1-5 years (30%), followed by 6 months-1 year age group (25%). Forty-five (75%) females had VF while 15 (25%) had perineal fistula. Intraoperative complication was vaginal tear seen in 6 (10%) patients followed by rectal tear seen in 3 (5%) patients. Early post-operative complications were seen in 9 (15%) patients. Wound infection was the most common complication seen in 5 (8.3%) patients, wound dehiscence in 3 (5%) patients and retraction of rectum in 1 (1.6%) patient. Late post-operative complications were seen in 24 (40%) patients. Perineal excoriation was the most common complication seen in 6 (10%) patients, constipation seen in 5 (8.3%) patients, anal stenosis in 4 (6.6%) patients and mucosal prolapse in 4 (6.6%) patients. The single-staged ASARP procedure resulted in satisfactory outcomes. It is an excellent procedure for females with VF and perineal fistula. Appropriate selection, preparation of patient, optimal correction with minimal sphincter damage and needful post-operative care of wound give excellent cosmetic and functional outcomes in terms of continence. It also decreases the burden on treating the surgeon, family and psychological stress on the patients and parents.

Sclerotherapy with 3% polidocanol foam for the treatment of mucocutaneous bridges and/or residual piles after open excisional hemorrhoidectomy.

Injection sclerotherapy is an effective and safe treatment in selected cases. It might be used as the first treatment for I-III degree hemorrhoidal disease (HD), but also as a bridge therapy for more severe cases not amenable to invasive treatments. However, concerning the long-term recurrence rate, open excisional hemorrhoidectomy remains the gold standard in cases of III- and IV-degree HD. In this context, it is recommended to perform the excision of no more than three piles and to preserve the muco-cutaneous bridges to avoid post-operative anal stenosis. The aim of this study is to evaluate surgical outcomes and efficacy of the combined treatment of open excisional hemorrhoidectomy and the use of ST on the remnant muco-cutaneous bridges/residual piles. This was a single-center retrospective study and a total of 18 patients with IV-degree HD, aged between 18 and 75years with symptomatic HD according to the Goligher classification, were enrolled between January 2023 and June 2023 and their follow-up continued until October 2023 after reaching 3months of follow-up. The Hemorrhoidal Disease Symptom Score (HDSS), the Short Health Scale for HD (SHS-HD) score and the Vaizey Incontinence Score were used to assess symptoms and their impact on quality of life and continence. A total of 77.8% (14/18) of the patients were symptom-free (hemorrhoidal disease symptom score (HDSS) score = 0) after 3months. Moreover, a statistically significant decrease in the median HDSS and short health scale for HD (SHS-HD) score was registered from 16 preoperatively (T0) to 2 at 3-month follow-up (T3). Neither post-operative bleeding nor any type of complications occurred. The use of sclerotherapy in combination with the traditional open excisional hemorrhoidectomy has shown promising results. Further structured studies are needed and greater dissemination and education of the general surgeon on the subject is necessary.

Massive sigmoid megacolon due to giant fecaloma: A case report of anal stricture

BackgroundA fecaloma is a mass of hardened feces in the colon or rectum, more solid than typical impacted feces, leading to severe intestinal distension. It predominantly affects elderly, frail individuals, children with anorectal deformities, and patients with conditions such as Chagas disease, Hirschsprung's disease, and spinal injuries. Case ReportWe report the case of a 34-year-old man with a history of anal imperforation and subsequent anal stricture, who presented with a massive megacolon due to a giant fecaloma. The patient experienced progressive abdominal distension, colicky pain, and an inability to pass stool for 15 days. Physical examination revealed a tender, distended abdomen and impacted feces in the rectum. Laboratory tests and imaging studies confirmed the diagnosis. An emergency laparotomy revealed a 30 × 30 cm dilated sigmoid colon filled with 15–25 kg of fecal material. The fecaloma was removed via enterectomy, and a Hartmann's procedure with colostomy was performed. Histopathological examination showed no evidence of malignancy. Post-operatively, the patient recovered well and was discharged in good condition. ConclusionThis case highlights the presentation and surgical management of a giant fecaloma causing megacolon. Prompt surgical intervention is critical in managing severe fecaloma to prevent life-threatening complications.

HIV-associated rectovaginal fistulae in children: a single-centre retrospective study in the antiretroviral era

PurposeAcquired rectovaginal fistulae (RVF) are a complication of paediatric HIV infection. We report our experience with the surgical management of this condition.MethodsWe retrospectively reviewed the records of paediatric patients with HIV-associated RVF managed at Chris Hani Baragwanath Academic Hospital (2011–2023). Information about HIV management, surgical history, and long-term outcomes was collected.ResultsTen patients with HIV-associated RVF were identified. Median age of presentation was 2 years (IQR: 1–3 years). Nine patients (9/10) underwent diverting colostomy, while one demised before the stoma was fashioned. Fistula repair was performed a median of 17 months (IQR: 7.5–55 months) after colostomy. An ischiorectal fat pad was interposed in 5/9 patients. Four (4/9) patients had fistula recurrence, 2/9 patients developed anal stenosis, and 3/9 perineal sepsis. Stoma reversal was performed a median of 16 months (IQR: 3–25 months) after repair. Seven patients (7/9) have good outcomes without soiling, while 2/9 have long-term stomas. Failure to maintain viral suppression after repair was significantly associated with fistula recurrence and complications (φ = 0.8, p < 0.05).ConclusionWhile HIV-associated RVFs remain a challenging condition, successful surgical treatment is possible. Viral suppression is a necessary condition for good outcomes.

Are the complications after laparo-assisted endo-rectal pull-through for Hirschsprung disease related to the change of the anal tone?

The main advantage of the laparo-assisted transanal endorectal pull-through technique (LA - TERPT) for Hirschsprung Disease (HD) is the respect to the rectal-anal anatomy. Postoperative complications have been observed recently. The present study aims to determine how often these postoperative complications occur in these patients. From January 2009 to December 2018, a retrospective analysis was conducted on 36 children (25 males) with HD who underwent LA-TERPT. Data were collected on the age of diagnosis and surgery, sex, the presence of other pathologies, and cases of enterocolitis. In all cases, anorectal manometry (ARM) was performed to evaluate the anal tone. The median age at diagnosis was 2 months and the mean age at surgery was 5 months. Nine related pathologies were identified: five cases of Down syndrome, one case of hypertrophic stenosis of the pylorus, atresia of the esophagus, polydactyly, and anorectal malformation. A patient with total colonic aganglionosis was identified through laparoscopic serummuscular biopsies. Enterocolitis was diagnosed in 7 cases before and 6 after surgery. At follow-up, the complications recorded were: 5 cases of constipation (treated with fecal softeners), one case of anal stenosis (patient with anorectal malformation), 16 cases of soiling (treated with enemas) and 1 child with fecal incontinence (treated with a transanal irrigation system). The ARM was performed in all 36 cases and showed normal anal tone, except for one case with anal hypotonia. LA-TERPT is an important surgical technique for HD. According to the literature, soiling is the most main complication after HD surgery, probably due to "pseudo-incontinence" with normal anal sphincter tone.

Aphallia with Anal Stenosis and Congenital Cyanotic Heart Disease: A Rare Case Report

Aphallia, an extremely rare urogenital anomaly, presents complex challenges in diagnosis and management. This anomaly, often accompanied by other congenital malformations, necessitates multidisciplinary care, and careful consideration of treatment priorities. We describe a case of a neonate diagnosed with aphallia along with anal stenosis, bilateral hydroureteronephrosis, and tetralogy of Fallot. Despite prompt intervention plans, the neonate’s condition deteriorated rapidly, highlighting the urgency and complexity of managing aphallia-associated complications. While embryological insights offer some understanding of its etiology, the clinical manifestation of aphallia underscores the need for immediate supportive measures and thoughtful decision-making regarding gender assignment and surgical interventions. Beyond medical considerations, emotional and psychological support for families navigating treatment decisions is paramount.

Оптимізація хірургічного лікування природженого анального та ректального стенозів у дітей

Congenital anal (CAS) and rectal stenosis (CRS) are variants of anorectal malformations (ARM) in children. Aim - to evaluate the results of surgical correction of CAS and CRS, based on this, to develop the main tactical requirements for the treatment of this complex pathology in children. Materials and methods. The study included 18 children with congenital anorectal stenosis: 7 (38.9%) - with CAS, 11 (61.1%) - with CRS, which accounted for 11.7% of all treated anorectal anomalies (n=154). The ratio of boys to girls was 5:1. After complex diagnostics, in 44.4% (n=8) of children were found to have associated malformations: 42.9% (n=3) of patients with CAS and 45.5% (n=5) - with CRS. Results. All (n=7) patients with CAS underwent one-stage surgical correction, without complications. In 90.9% (n=10) of children with CRS staged surgical treatment was performed, and one-stage in 9.1% (n=1). At the stages of primary correction of CRS postoperative complications occurred in 18.2% (n=2): stoma stenosis (n=1); urethro-perineal fistula (n=1), which were surgically corrected. After the primary correction of CRS was completed, persistent constipation was noted in 2 (18.2%) children. Repeated staged reconstructive operations were performed on these patients. Conclusions. The use of the diagnostic, treatment and rehabilitation algorithm for CRS, developed in the clinic, made it possible to obtain good results in the long postoperative period in 63.6% (n=7) of children, and satisfactory results in 36.4% (n=4). The improved technique of surgical treatment of CAS made it possible to carry out primary correction of the defect with a good functional result in 71.4% (n=5) and satisfactory results in 28.6% (n=2) of children. The research was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research. The authors declare no conflict of interest.

Characteristics and Clinical Features of Anorectal Malformations Without Fistula: A Systematic Literature Review

Anorectal malformation (MA) without fistula is a form of congenital abnormality that is often found in newborn babies. This study aims to identify the characteristics and clinical features of MA without fistula based on the latest scientific evidence. A systematic search was conducted on the PubMed, Scopus, and Web of Science databases using relevant keywords. Inclusion criteria included observational studies reporting the characteristics and clinical features of MA without fistula in humans. Two independent researchers conducted study selection, data extraction, and study quality assessment using the JBI Critical Appraisal Checklist tool. A total of 25 studies (2018-2024) involving 1548 MA patients without fistula met the inclusion criteria. The majority of patients were male (62%). The average age at diagnosis is 2 days. The most frequently reported clinical symptoms were absence of anus (100%), abdominal distension (78%), and vomiting (65%). The most common classification of MA without fistula was perineal (45%), followed by vestibular (30%) and cloacal (25%). The most frequently performed definitive surgery was perineal anoplasty (55%), followed by posterior sagittal anorectoplasty (PSARP) (35%) and laparoscopic-assisted anorectoplasty (10%). The most frequently reported postoperative complications were anal stenosis (15%), surgical wound infection (10%), and rectal prolapse (5%). MA without fistula is more common in male babies. The main clinical symptoms are absence of anus, abdominal distension, and vomiting. The perineal classification is the most common. Perineal anoplasty is the most frequently performed definitive surgery. Post-operative complications that need to be watched out for are anal stenosis, surgical wound infection, and rectal prolapse.

Insights into Atresia Ani Type IV in Felis catus: Preliminary Epidemiolocal Findings Associated with Surgery.

Atresia Ani (AA) is a rare congenital anomaly in companion animals affecting rectal and anal development. Its incidence in cats remains unreported. This retrospective study aimed to characterize age, body condition, fistula size, and perioperative outcomes in Type IV Atresia Ani (with recto-vaginal fistula) in female cats. Surgical intervention is the primary treatment. Conducted over 2 years, the study included nine female cats diagnosed with Type IV Atresia Ani and recto-vaginal fistula undergoing surgery. Statistical analysis used the R program (version 4.2.1) with Rstudio®® extension. Significant results were observed at a 95% confidence interval and p < 0.05. The condition had an incidence of 4.7% among the 192 cats evaluated over a 2-year period. The findings suggest that a body condition score of 3, an age of 3 to 4 weeks, and a fistula length of 1 to 2 mm correlated with better surgical outcomes, reducing the likelihood of fecal incontinence and anal stenosis development, and enhancing defecation awareness during the perioperative period. This study is the first to report the disease incidence in cats undergoing surgery, according to the authors' knowledge.

Transsphincteric Repair of Rectourethral Fistulas in Combination With Dartos Muscle Flap Interposition Following Radical Prostatectomy

OBJECTIVETo present our experience with a novel technique that combines the York–Mason transsphincteric approach with dartos muscle flap interposition to treat rectourethral fistulas. METHODSWe extracted records from our prospectively kept database of 35 procedures conducted for treating rectourethral fistulas during 2002–2023; the York–Mason approach was combined with dartos muscle flap interposition in five cases, performed for treating rectourethral fistulas due to radical prostatectomy, all of which were referral cases. RESULTSAll five patients were successfully treated and followed up for a median of 70.0 months without recurrence. Before the fistula repair, all had a diverting stoma. In all cases, the first voiding cystourethrogram revealed a healed fistula. The posterior and the scrotal incisions healed uneventfully. All patients reported normal voiding and no urinary incontinence. To date, the stoma has closed in three patients, all of whom had intact fecal continence and no postoperative anal stenosis. CONCLUSIONThe transsphincteric modified York–Mason approach combined with dartos muscle flap interposition resulted in complete healing of rectourethral fistulas.

Modern methods of treatment of anal stenosis

Objective. To develop and put into practice a new combined method of anal stenosis surgical treatment based on laser plastic surgery of tissues with a diode laser. Assess the effectiveness of the technique based on the analysis of immediate and long-term results, postoperative complications, peculiarities of technical implementation, and features of the quality of patients` life. Materials and methods. The study involved 68 patients with anal stricture after the anal and (or) rectal surgery. All patients underwent laser correction of postoperative scar tissue. According to indications, botulinum toxin was injected into the internal sphincter and (or) PRP autoplasma perarectally. Surgery was performed under intravenous anesthesia with the addition of tumescent anesthesia or local anesthesia. Laser radiation from a diode device with a wavelength of 1.56 microns and a power of 10 W was applied. Results. There are no restrictions on laser correction of anal stenosis regardless of the type and complexity of anal stenosis, it is technically easy to use, minimizes the risk of postoperative complications and relapse of the disease, and has a highly effective treatment result. Conclusions. The technique is characterized by versatility and ease of use, highly effective results, high quality of patients` life, and it can be used routinely on an outpatient basis.

Efficacy of surgical treatment of perianal infection in patients with hematological malignancy.

The efficacy of surgical intervention for perianal infection in patients with hematologic malignancies is not well established. Therefore, our study aimed to investigate the clinical efficacy and complications of surgical treatment of perianal infection in patients with hematologic malignancies. This retrospective study included patients with hematological malignancies who were diagnosed with perianal infections and treated at the China Aerospace Science & Industry Corporation 731 Hospital between 2018 and 2022. Patient characteristics, hematological data, surgical intervention, and complications, including recurrence and mortality, were analyzed. This study included 156 patients with leukemia aged 2 months to 71 years who were treated surgically for perianal infection, comprising 94 males and 62 females. Perianal infection included 36 cases of abscesses, 91 anal fistulas, and 29 anal fissures accompanied by infection. A total of 36 patients developed severe complications postoperatively, including 4 patients who died, 6 patients with severe incision bleeding, 18 patients with severe pain, 6 patients with sepsis, 12 patients who needed reoperation, 15 patients with hospitalization for more than 2 weeks, and 3 patients with anal stenosis; none of the patients developed anal incontinence. Additionally, risk factors for postoperative complications of perianal infection in patients with hematologic malignancies include leukopenia, agranulocytosis, thrombocytopenia, depth of abscess and not undergone an MRI. Surgical intervention may improve the prognosis of patients with perianal abscess formation, particularly in patients who show no improvement with medical therapy and those who develop perianal sepsis. Granulocytopenia and thrombocytopenia should be improved before surgery, which can significantly reduce postoperative complications. Although these findings are from a case series without a comparator, they may be of value to physicians because to the best of our knowledge, no randomized or prospective studies have been conducted on the management of perianal infections in patients with hematological malignancies.

Can Anorectal Stenosis be Managed With Dilations Alone? A PCPLC Review

PurposeCongenital anorectal stenosis is managed by dilations or operative repair. Recent studies now propose use of dilations as the primary treatment modality to potentially defer or eliminate the need for surgical repair. We aim to characterize the management and outcomes of these patients via a multi-institutional review using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) registry. MethodsA retrospective database review was performed using the PCPLC registry. The patients were evaluated for demographics, co-morbidities, diagnostic work-up, surgical intervention, current bowel management, and complications. Results64 patients with anal or rectal stenosis were identified (57 anal, 7 rectal) from a total of 14 hospital centers. 59.6% (anal) and 42.9% (rectal) were male. The median age was 3.2 (anal) and 1.9 years (rectal). 11 patients with anal stenosis also had Currarino Syndrome with 10 of the 11 patients diagnosed with a presacral mass compared to only one rectal stenosis with Currarino Syndrome and a presacral mass. 13 patients (22.8%, anal) and one (14.3%, rectal) underwent surgical correction. Nine patients (8 anal, 1 rectal) underwent PSARP. Other procedures performed were cutback anoplasty and anterior anorectoplasty. The median age at repair was 8.4 months (anal) and 10 days old (rectal). One patient had a wound complication in the anal stenosis group. Bowel management at last visit showed little differences between groups or treatment approach. ConclusionThe PCPLC registry demonstrated that these patients can often be managed successfully with dilations alone. PSARP is the most common surgical repair chosen for those who undergo surgical repair. Level of EvidenceIII.