Caring for Your Child After Reconstructive Surgery for an Anal Malformation
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Anorectal malformations are birth defects that occur when the anus and rectum do not develop the way they should
Anorectal malformations occur in approximately 1 in every 5000 live births
The malformation can range from small to very complicated
Posterior sagittal anorectoplasty (PSARP) is the surgery performed to correct anorectal malformations
During PSARP, a surgeon creates an anus to correct the location on the child's body
In more complex or complicated malformations, the PSARP procedure can also involve surgery of the vagina and urinary structures
Steri-Strips covering abdominal incisions will fall off on their own in 7 to 14 days
Removing Steri-Strips too soon can cause the skin to break open
Children should not be held in a straddle position for 3 months after PSARP surgery
Straddle positioning (legs separated or opened wide) can occur when carrying a child on the hip or in front or back carriers
Toys that put a child into a straddle position (rocking horse, bike, infant bouncing toy) should not be used for 3 months after surgery
Children should not participate in rough play, lift anything heavy, or play contact sports for 2 weeks after surgery
In most cases, children can begin to take a bath or swim 2 weeks after surgery
If a child has a Foley catheter draining their urine, they must wait until the catheter is removed before they can bathe or swim
Foley catheters placed after PSARP surgery need to be removed 1 to 2 weeks after hospital discharge
When the balloon tube of a Foley catheter is cut, the catheter will easily be able to be pulled out or will fall out on its own
Parents should cut the balloon port of the Foley catheter at bedtime using scissors provided in the hospital
If the catheter does not come out easily or if the child doesn't urinate in 8 hours after catheter removal, parents should call the medical team
After PSARP surgery, stool patterns may change as the child heals, ranging from very loose and watery several times a day to very thick and infrequent
Children may be prescribed MiraLax and/or Senna upon discharge to ensure daily stooling
Laxatives help to soften the stool so hard stool is not passing through the child's new anal opening
The type of foods a child eats is very important in bowel management after PSARP
Laxative foods help stool to be softer and looser, while constipating foods help stool be thicker and harder
If a child is breastfed and stooling well, MiraLax and Senna may not be started until they begin eating solids and their stools start to thicken
Parents should call the medical team immediately if the child has a fever of 101°F or higher
Parents should call the medical team immediately if the incision has yellow or green liquid drainage
Parents should call the medical team immediately if the surgical site edges are pulling open
Parents should call the medical team immediately if the catheter comes out of the child
Parents should call the medical team immediately if the child is vomiting and is not able to eat food or drink liquids