Abstract
We encountered 3 cases involving only male children of anorectal malformation (ARM) with recto-urethral fistula. In all cases, the level of the rectal pouch was below the I-line. We performed anterior perineal anoplasty and obtained satisfactory results in all cases. Case 1 involved a long fistulous tract running parallel to the urethra from the rectal pouch to the spongy urethra; the tract was thought to be an ano-penile-urethral fistula. Case 2 showed a rectourethral fistula and urethro-cutaneous fistula that opened to the median raphe of the scrotum and was thought to be an ano-urethro-cutaneous fistula. They were rare, unclassified cases of ARM. Case 3 involved a recto-urethral fistula. The patient underwent colostomy at birth, and then underwent anterior perineal anoplasty at 4 ～6 months of age. In this procedure, we dissected the rectal pouch and the fistula using an endoscope and a guide wire from the colostomy as an index. This procedure allowed dissection of the rectum and fistula with minimal damage to the pelvic plexus and anal sphincter. This procedure may be feasible for such cases of ARM.
