Surgical implications of genitourinary tract anomalies in patients with imperforate anus.

Genitourinary anomalies in patients with imperforate anus are a frequent source of significant morbidity. We report a retrospective study of 64 genitourinary procedures performed on 23 patients. Renal, collecting system, bladder and perineal anomalies were encountered in 65%, 83%, 87% and 65% of these complex cases, respectively. A total of 70% of the patients required intermittent catheterization due to bladder dysfunction. Surgical alternatives, complications of management and functional outcomes are reviewed in detail. Genitourinary reconstruction is best undertaken as an integral part of imperforate anus reconstruction. Failure to do so results in the loss of surgical alternatives, unnecessary reoperative procedures and compromised outcomes.