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Update Course Rewind 2025: Perineal Body–Preserving PSARP: The New Standard?
hosted by Dr. Jill Knepprath
Chapter 1 of 4 · Fundamentals
Introduction
Introduction and Session Overview
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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
Perineal body-preserving PSARP is basically the same technique one would do in a bulbar fistula, but applied to a vestibular fistula, cleaning up the lateral planes before coming around the front.
Perineal body-preserving PSARP allows patients to go home earlier compared to classic PSARP.
With perineal body-preserving PSARP, the surgeon does not have to worry about breakdown in the perineal body postoperatively.
Perineal body-preserving PSARP is harder technically than opening it all the way anteriorly in a standard PSARP.
If the surgeon is not sure where the anterior rectal wall is and where the vagina is during perineal body-preserving PSARP, conversion to a standard PSARP is appropriate.
2023 publications on perineal body-preserving PSARP demonstrated at one year follow-up: no dehiscence, no prolapse, and only 13% of patients required revision of their anal stricture.
Two-thirds of patients undergoing perineal body-preserving PSARP went home on postoperative day one.
Perineal body-preserving PSARP is a good choice for patients but can be a trickier approach than standard PSARP.
Conversion to the standard PSARP approach is a valid pivot when there is doubt about anatomy during perineal body-preserving PSARP.