Abstract
Fifteen cases of recto-bulbar fistula were reviewed. Twelve cases had a fistula entering into the bulbous urethra below the membranous urethra, whereas 3 had the fistula entering into the penile urethra. The latter is called an unusual type. Radiographic findings of the rectum ending below the I-line and the presence of a long fine fistula entering into the penile urethra are characteristic to this type of anomaly. It was interesting to recognize several vertical folds in the mucosal surface of the blind end of the rectum which might be called "anal crypt" in these cases. Since similar finding was observed in most low type deformities including covered anuscomplete (7 out of 8 cases), ano-cutaneous fistula and anal membrane stenosis, the unusual type might had better classified in the low type anomaly. Although these three unusual cases were treated by sacro-perineal approach described by Stephens, et al., they might be operated perineally even in the neonatal period avoiding colostomy. Management of a long fistula to the penile urethra remains to be solved in treating these cases perineally.
