During six years period from 1977 through 1982, five female infants with imperforale anus and rectocloacal fistula were treated in our institution. From the experiences obtained by the management of these cases, our conclusions are as follows; 1. Simultaneous three organs radiogram was very important not only for the exact diagnosis but also for the choice of surgical procedure. 2. For cases of low confluence in the radiogram, which showed the vagina, urethra and rectum communicated above I line, Hendren's perineal vaginoplasty and anoplasty were indicated. Its operative results were excellent. 3. For cases of high confluence in the radiogram, which showed the vagina, urethra and rectum communicated above P-C line, combined abdomino-perineal vaginal and rectal pullthrough were indicated. 4. Raffensperger's neonatal vaginal pullthrough was performed in the case with huge hydrometrocolpos, whereas in the case of normal sine vagina, Hendren's abdomino-perineal vaginal pullthrough was performed. Hendren's operation is very meticulous procedure and might have some risks of injury to innervation to bladder neck. More investigation should be made to abdomino-perineal vaginal pullthrough.
