Post PSRRP anorectol manometry--experience of 115 cases of imperforate anus.

ABSTRACT

The conventional treatment of high and intemiediate anomalies of anorectal malformations is proximal pelvic colostomy in neonate (day 1) followed by PSARP (postsagittal anorectoplasty) by the age of 4-6 months and closure of colostomy when adequate dilatation of neo-anus has been performed using Nol 2 or 13 Hegar's dilator or No4 St Mark's anal dilator, It is usually done 3 months after the PSARP operation (anorectal pull through), ie, around 9 months. So the child born without anus in the perineum should be able to pass stool via his or her neo-anus by the age of 9 months and they should ideally be penneally continent. The present study, between August 1993 and December 1999, on the anorectal continence evaluation by doing anorectal manometry was carried out in 115 babies who underwent PSARP operation and subsequent closure of the colostomy. The study showed intermediate anomalies dominated the picture in both males and females (103 babies belonging to intermediate anomalies and 12 babies having high anomalies). In all these children the results of continence have been studied both clinically (Kiesewetter criteria) and by anorectal manometry.