Urinary Tract Concerns When Undergoing Surgery

Another one of the questions is, uh, what are the concerns to the urinary tract when a child is undergoing any sort of colorectal surgical procedure? One of the greatest contributions to children with interectal malformations has come from Doctor Alberto Pena and his understanding of how to safely perform surgical procedures to correct and address the interectal malformation, and uh that is a surgical procedure called a PSARP. That's a capital P S ARP and it stands for posterior, meaning going from the baby's back, sagittal in the midline. Anor ectoplasty is to fix the anorectal malformation, and the genius of what Doctor Pena's approach was, was going in the midline, it avoids any injury to the nerves of the urinary tract. And there have been studies that are done that have looked at the functionality of the urinary tract in children who have undergone PSAP surgical procedures, and the incidence of urological involvement when we've had baseline before surgery and after surgery is low. It's not zero. There may be some concerns, but it's not as significant as what used to happen with previous surgical interventions that were done historically for children with interectal malformations. Um, and again, you know, working in a collaborative manner, we make sure that we, the urologists, are available whenever these children are undergoing their surgery. So when the fistula is being removed from the urinary tract, we can be there to assist in the reconstruction of the urinary tract if needed, uh, guiding the management of the urethra after the surgery, and if needed, say, you know, this bladder is not going to work well after the surgery, so let's go ahead and um come up with a plan as to how we're going to make sure that the child empties their bladder properly until we can. Better define that problem and come up with a more sustainable plan. So again, another shout out to the reason why your child should always be getting collaborative care.