2010 Volume 46 Issue 7 Pages 1151-1155
We report a case where anal plugs (APs) were used for FI management. A 10-year-old boy with rectourethral fistula underwent sigmoid colostomy on the first day of his life. At 9 months of age, he underwent sacroperineal anoplasty. The sigmoid colostomy was closed one month later, and a few days later fecal discharge via the urethra was observed. Contrast enema revealed recurrence of the RUF. Reoperations for the RUF were performed at the ages of 3 and 5 years, but were unsuccessful. At 7 years and 5 months of age, he was referred to our institute because of refractory RUF with repeated urinary tract infections. He underwent an endorectal pull-through operation using a combined abdominal and posterior sagittal approach. The RUF was completely closed, but he suffered from intractable FI. We planned to create a stoma or administer a Malone antegrade continence enema, but the patient and his mother refused to undergo another surgery. We started to use the Conveen AP to minimize discomfort and odors caused by incontinence. The first time he used an AP, he pulled it out halfway through because of anal discomfort. He gradually adapted to the anal discomfort, could keep the AP in for a whole day, and managed to successfully control his incontinence. However, the APs are not a general or permanent treatment for intractable FI in children with anal malformation. APs enable patients to be relieved of anxiety associated with FI.
