A call to ARMs: Accurate identification of the anatomy of the rectourethral fistula in anorectal malformations
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Read the article on jpedsurg.org ↗Article · May 2019 · 1 min read
In brief
In brief
This article presents a standardized anatomic classification system for rectourethral fistulae in males with anorectal malformations (ARM). The authors provide a visual reference tool to improve interpretation of distal colostograms and accurately determine fistula level, which guides surgical approach selection between posterior sagittal incision versus laparoscopic/open abdominal techniques.
Written by the GCMD Library team from the article.
Recto-urethral fistulae are the most common finding in males born with an anorectal malformation (ARM). A high pressure distal colostogram is an important tool in visualizing the fistula, although the precise level at which the fistula communicates with the urethra may be difficult to interpret and is not reported in a uniform manner. This anatomy affects the surgical plan; determining the likelihood that the rectum is reachable via a posterior sagittal incision or better approached through the abdomen via laparoscopy or laparotomy helps counsel families and stratifies diagnoses for outcomes work. Herein we present a figure used at our Center to assist with correlating findings on the distal colostogram with the anatomic level of the recto-urethral fistula in males with anorectal malformations.