Urogenital Tract Abnormalities Associated with Congenital Anorectal Malformations

Genitourinary anomalies in patients with imperforate anus are a frequent source of significant morbidity. Variability of reports on the incidence of associated anomalies with imperforate anus mandates investigation on this issue. The case records and imaging studies of 105 patients who underwent surgery for imperforate anus over a 10-year period are retrospectively reviewed. Voiding cystouretherography, intra venous pyelography (IVP) and ultrasound were performed in patients with intermediate or high level anorectal lesions. During 10 years, there were 48 boys (45.7%) and 57 girls (54.3%) with imperforate anus. Genitourinary anomalies were seen in 34 (48.6%) patients with intermediate or high level anorectal lesions. Eighteen of them (52.9%) were shown to have vesicouretral reflux, only 6 of them required surgical correction. Vesicoureteral reflux was the most prominent urologic anomaly; other anomalies such as ureteropelvic junction (UPJ) stenosis, hydronephrosis, hypospadias, renal agenesis and undescended testis were seen in these series. Patients with anorectal malformations should be evaluated for urinary tract and spinal anomalies.