Effects of Reconstructive Surgery on Bladder Function in Patients with Anorectal Malformations

No AccessJournal of UrologyPediatric Urology1 Dec 2014Effects of Reconstructive Surgery on Bladder Function in Patients with Anorectal Malformations Hendt P. Versteegh, Katja P. Wolffenbuttel, Cornelius E.J. Sloots, Gerard C. Madern, Joop van den Hoek, Rene M.H. Wijnen, and Ivo de Blaauw Hendt P. VersteeghHendt P. Versteegh Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author , Katja P. WolffenbuttelKatja P. Wolffenbuttel Department of Pediatric Urology, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author , Cornelius E.J. SlootsCornelius E.J. Sloots Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author , Gerard C. MadernGerard C. Madern Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author , Joop van den HoekJoop van den Hoek Department of Pediatric Urology, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author , Rene M.H. WijnenRene M.H. Wijnen Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author , and Ivo de BlaauwIvo de Blaauw Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands Department of Pediatric Surgery, Radboud University Medical Center, Nijmegen, the Netherlands More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.06.080AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Bladder dysfunction is common in patients with anorectal malformations and can be congenital or acquired as a consequence of surgery. We investigated the effects of surgical correction of anorectal malformations on bladder function. Materials and Methods: The charts of all 341 patients who underwent surgery at our center between 1990 and 2010 were retrospectively analyzed for preoperative and postoperative videourodynamics. A total of 52 patients were eligible for study inclusion. Each assessment was scored according to International Children’s Continence Society standards. Results: Urodynamic study indicated normal bladder function preoperatively in 36 patients (69%) and postoperatively in 37 (71%). Median bladder emptying efficiency and relative bladder capacity changed significantly after posterior sagittal anorectoplasty. Bladder function according to International Children’s Continence Society standards did not change postoperatively in 43 patients (83%). In 1 of 4 patients with deterioration of bladder function the deterioration could be attributed solely to surgery. Clinical outcome was available in 38 patients and showed complete urinary continence with spontaneous voiding in 24 (63%). Seven of 25 patients (28%) with preoperative videourodynamics indicating normal bladder function demonstrated dysfunctional voiding at latest followup. Conclusions: Urodynamic and clinical outcomes after anorectal malformation repair are good, with 63% of patients being continent of urine. Urodynamic studies are of limited value in preoperative settings in these patients. Current techniques of reconstructive surgery for anorectal malformations seem to preserve bladder function in the majority of patients. References 1 : Anorectal malformations. Orphanet J Rare Dis2007; 2: 33. Google Scholar 2 : Posterior sagittal anorectoplasty: important technical considerations and new applications. J Pediatr Surg1982; 17: 796. Google Scholar 3 : Total urogenital mobilization—an easier way to repair cloacas. J Pediatr Surg1997; 32: 263. Google Scholar 4 : The surgical management of persistent cloaca: results in 54 patients treated with a posterior sagittal approach. J Pediatr Surg1989; 24: 590. 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Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByRitchey M (2018) This Month in Pediatric UrologyJournal of Urology, VOL. 192, NO. 6, (1591-1592), Online publication date: 1-Dec-2014.Cain M (2018) Anorectal Malformations and Potential Urological Problems—What is the Pediatric Urologist’s Role?Journal of Urology, VOL. 192, NO. 6, (1597-1598), Online publication date: 1-Dec-2014. Volume 192Issue 6December 2014Page: 1789-1793 Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordsneurogenicurinary bladderanorectal anomaliesurinary incontinenceurodynamicsMetricsAuthor Information Hendt P. Versteegh Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author Katja P. Wolffenbuttel Department of Pediatric Urology, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author Cornelius E.J. Sloots Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author Gerard C. Madern Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author Joop van den Hoek Department of Pediatric Urology, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author Rene M.H. Wijnen Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands More articles by this author Ivo de Blaauw Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands Department of Pediatric Surgery, Radboud University Medical Center, Nijmegen, the Netherlands More articles by this author Expand All Advertisement PDF DownloadLoading ...