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German Network for Congenital Uro-REctal Malformations: first evaluation and interpretation of postoperative urological complications in anorectal malformations

  • Stefanie Maerzheuser
  • Ekkehart Jenetzky
  • Nadine Zwink
  • Heiko Reutter
  • Enrika Bartels
  • Sabine Grasshoff-Derr
  • Stefan Holland-Cunz
  • Stuart Hosie
  • Eberhard Schmiedeke
  • Nicole Schwarzer
  • Nicole Spychalski
  • Gabriel Goetz
  • Dominik Schmidt
Original Article

Abstract

Objective

The aim of the German Network for Congenital Uro-REctal Malformations is to collect data of affected patients with anorectal malformation (ARM) or extrophy–epispadias complex, and to investigate molecular causes, clinical implications, and psychosocial outcome. The current issue was to assess the postoperative sequelae related to lower urinary tract dysfunction in patients with ARM.

Materials and methods

Two hundred and sixty-seven patients with ARM (112 females, 155 males, median age 6 years, range 0–56 years) were investigated via standardized case report forms comprising interview, analysis of medical data, and personal questionnaires.

Results

Thirty-two patients (12%, 23 males, 9 females) suffered from neurogenic bladder dysfunction, mainly associated with recto-urethral fistula (11 cases, 34%), and recto-vesical fistula (6 cases, 19%). Sixty-eight patients (26%, 35 males, 57 females) have experienced lifetime urinary tract infection, primarily associated with recto-urethral fistula (21 cases, 31%), and vestibular fistula (13 cases, 19%). According to type of operation, the highest number of postoperative urologic problems was reported after abdominosacroperineal pull-through.

Conclusion

Besides reconstructing the ARM, another main goal is the preservation of lower urinary tract function. In our data, there seems to be a close correlation between operative strategies and postoperative complications.

Keywords

Anorectal malformation Postoperative complication Neurogenic bladder dysfunction Urinary tract dysfunction Cure-Net 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Stefanie Maerzheuser
    • 1
  • Ekkehart Jenetzky
    • 2
  • Nadine Zwink
    • 2
  • Heiko Reutter
    • 3
    • 4
  • Enrika Bartels
    • 3
  • Sabine Grasshoff-Derr
    • 5
  • Stefan Holland-Cunz
    • 6
  • Stuart Hosie
    • 7
  • Eberhard Schmiedeke
    • 8
  • Nicole Schwarzer
    • 9
  • Nicole Spychalski
    • 11
  • Gabriel Goetz
    • 10
  • Dominik Schmidt
    • 3
    • 1
  1. 1.Department of Pediatric SurgeryCharité Universitätsmedizin BerlinBerlinGermany
  2. 2.Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research CentreHeidelbergGermany
  3. 3.Institute of Human GeneticsUniversity of BonnBonnGermany
  4. 4.Department of NeonatologyChildren’s Hospital, University of BonnBonnGermany
  5. 5.Department of Pediatric SurgeryUniversity Hospital WuerzburgWuerzburgGermany
  6. 6.Department of Pediatric SurgeryUniversity of HeidelbergHeidelbergGermany
  7. 7.Department of Pediatric SurgeryKlinikum Schwabing, Technical University MunichMunichGermany
  8. 8.Department of Pediatric Surgery and UrologyCentre for Child and Youth HealthBremenGermany
  9. 9.SoMA e.V. Self-Help organization for people with anorectal malformationMunichGermany
  10. 10.Department of Pediatric SurgeryUniversity of LeipzigLeipzigGermany
  11. 11.Department of Pediatric SurgeryCnopf’sche KinderklinikNurembergGermany

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