Operative Management of Anomalies in Males

Abstract

Anorectal malformations (ARM) represent a wide spectrum of defects. The terms low, intermediate, and high are arbitrary and not very useful in therapeutic or prognostic terms. Within the group of ARM traditionally referred to as high, there are defects with different therapeutic and prognostic implications. For instance, retroprostatic fistula and rectobladderneck fistula were both considered high, yet the first can be repaired with a posterior sagittal approach alone, but the second also requires an abdominal approach. The prognosis for each type is completely different. Therefore, anatomic descriptions of the malformations are more useful clinically (Table 20.1).