Postoperative Continence Assessment in Female Patients with Anorectal Malformations: A Tertiary Care Center Study

Background: Anorectal malformations (ARMs) include a group of congenital anomalies affecting the distal anorectum with frequent involvement of the urogenital tract. As modern surgical advancements have improved survival, attention has shifted toward assessment and optimization of bowel function, to...

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Main Authors: Anjana Kaza, K. T. Mandakini, Bhuvaneshwar Rao
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
Series:Journal of Indian Association of Pediatric Surgeons
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Online Access:https://journals.lww.com/10.4103/jiaps.jiaps_260_24
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author Anjana Kaza
K. T. Mandakini
Bhuvaneshwar Rao
author_facet Anjana Kaza
K. T. Mandakini
Bhuvaneshwar Rao
author_sort Anjana Kaza
collection DOAJ
description Background: Anorectal malformations (ARMs) include a group of congenital anomalies affecting the distal anorectum with frequent involvement of the urogenital tract. As modern surgical advancements have improved survival, attention has shifted toward assessment and optimization of bowel function, to improve the overall quality of life for affected children. Objective: The objective of this study was to evaluate the bowel functional outcomes for individual types of female ARMs after standardized management at a tertiary center. Materials and Methods: The present study included 35 female patients with anorectal malformations aged >3 years, who underwent single staged/staged ARM repair, and finished dilatation program. Patient demographics, type of ARM, surgeries performed, and postoperative complications were noted. Bowel function was assessed using the Krickenbeck scoring system for postoperative results. Those with continence issues underwent contrast enema and magnetic resonance imaging (MRI) pelvis. Results: The study included 24 patients with vestibular fistula, 7 with perineal fistula, 2 with rectovaginal fistula, and 2 with perineal canal. Voluntary bowel movement (VBM) was achieved in 34 (97.15%) patients post-ARM repair, constipation in 8 (22.85%) patients, and soiling in 2 (5.7%) patients. Of these, 3 patients had abnormal findings on contrast enema and 2 on MRI pelvis. Conclusion: VBM was achieved by majority of the females following ARM repair. Constipation was the most common functional complication. Soiling noted in 2 cases was due to overflow incontinence secondary to constipation. Early initiation of targeted bowel management showed improvement in affected subjects. The Krickenbeck scoring system for postoperative results is a quick, easy method of identifying patients with functional incontinence based on symptoms.
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spelling doaj-art-883244612fcb4624b752cea532f1fb3d2025-08-20T03:02:44ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92611998-38912025-07-0130445946310.4103/jiaps.jiaps_260_24Postoperative Continence Assessment in Female Patients with Anorectal Malformations: A Tertiary Care Center StudyAnjana KazaK. T. MandakiniBhuvaneshwar RaoBackground: Anorectal malformations (ARMs) include a group of congenital anomalies affecting the distal anorectum with frequent involvement of the urogenital tract. As modern surgical advancements have improved survival, attention has shifted toward assessment and optimization of bowel function, to improve the overall quality of life for affected children. Objective: The objective of this study was to evaluate the bowel functional outcomes for individual types of female ARMs after standardized management at a tertiary center. Materials and Methods: The present study included 35 female patients with anorectal malformations aged >3 years, who underwent single staged/staged ARM repair, and finished dilatation program. Patient demographics, type of ARM, surgeries performed, and postoperative complications were noted. Bowel function was assessed using the Krickenbeck scoring system for postoperative results. Those with continence issues underwent contrast enema and magnetic resonance imaging (MRI) pelvis. Results: The study included 24 patients with vestibular fistula, 7 with perineal fistula, 2 with rectovaginal fistula, and 2 with perineal canal. Voluntary bowel movement (VBM) was achieved in 34 (97.15%) patients post-ARM repair, constipation in 8 (22.85%) patients, and soiling in 2 (5.7%) patients. Of these, 3 patients had abnormal findings on contrast enema and 2 on MRI pelvis. Conclusion: VBM was achieved by majority of the females following ARM repair. Constipation was the most common functional complication. Soiling noted in 2 cases was due to overflow incontinence secondary to constipation. Early initiation of targeted bowel management showed improvement in affected subjects. The Krickenbeck scoring system for postoperative results is a quick, easy method of identifying patients with functional incontinence based on symptoms.https://journals.lww.com/10.4103/jiaps.jiaps_260_24anorectal malformationsfemale patientsfunctional outcometertiary carevestibular fistula
spellingShingle Anjana Kaza
K. T. Mandakini
Bhuvaneshwar Rao
Postoperative Continence Assessment in Female Patients with Anorectal Malformations: A Tertiary Care Center Study
Journal of Indian Association of Pediatric Surgeons
anorectal malformations
female patients
functional outcome
tertiary care
vestibular fistula
title Postoperative Continence Assessment in Female Patients with Anorectal Malformations: A Tertiary Care Center Study
title_full Postoperative Continence Assessment in Female Patients with Anorectal Malformations: A Tertiary Care Center Study
title_fullStr Postoperative Continence Assessment in Female Patients with Anorectal Malformations: A Tertiary Care Center Study
title_full_unstemmed Postoperative Continence Assessment in Female Patients with Anorectal Malformations: A Tertiary Care Center Study
title_short Postoperative Continence Assessment in Female Patients with Anorectal Malformations: A Tertiary Care Center Study
title_sort postoperative continence assessment in female patients with anorectal malformations a tertiary care center study
topic anorectal malformations
female patients
functional outcome
tertiary care
vestibular fistula
url https://journals.lww.com/10.4103/jiaps.jiaps_260_24
work_keys_str_mv AT anjanakaza postoperativecontinenceassessmentinfemalepatientswithanorectalmalformationsatertiarycarecenterstudy
AT ktmandakini postoperativecontinenceassessmentinfemalepatientswithanorectalmalformationsatertiarycarecenterstudy
AT bhuvaneshwarrao postoperativecontinenceassessmentinfemalepatientswithanorectalmalformationsatertiarycarecenterstudy