Results after posterior sagittal anorectoplasty: a new approach to high imperforate anus

Six patients, 3 to 12 months of age have undergone posterior sagittal anorectoplasty for high imperforate anus. A rectourethral fistula was present in all patients. The operative procedure performed was the method of de Vries and Pena, utilizing electrostimulation and identification of the external sphincter muscles. One patient required an abdominal operation as well as the perineal approach. There were no complications. Serial assessment was carried out over a period of 4 months to 2 1/2 years. Normal continence was achieved in three patients. Anorectal manometry was performed in five patients. Four of five patients had normal rectal sensation and normal mean anal canal pressures. These results suggest that this procedure is applicable to the young infant with high imperforate anus, and a satisfactory result can be anticipated.