Standardizing Perineal Body Assessment in Low ARM Management: A Call for Objective Criteria

We read with interest the study by Lindert and Curry proposing a pragmatic algorithm to guide surgical decision-making in females with low anorectal malformations (ARM) [1]. Their emphasis on functional parameters—anal calibration, sphincter response, and perineal body length—aligns with the growing focus on patient-centered outcomes in ARM care. Their finding that none of the conservatively managed patients required subsequent surgical intervention over a mean follow-up of 60 months lends compelling support to their approach.