Basic Anatomy and Physiology of Bowel Control

  • Alberto Peña
  • Andrea Bischoff


The authors present a summary of the most recent publications related with the etiology, pathogenesis, and genetics of anorectal malformations. Special attention is dedicated to the issue of the “modern anatomic findings.” A detailed description of the intrinsic anatomy of anorectal malformations is presented, in an effort to eradicate traditional concepts, based on repetition of myths and “sacred” concepts, without factual evidence such as the characteristics of the “internal sphincter,” “external sphincter,” and “puborectalis muscle.”

A brief description of the most important elements necessary to have bowel control is presented including (a) sensation, (b) sphincters, and (c) colonic motility. Contrary to the common belief, the authors emphasize the importance of rectosigmoid and colonic motility surpassing the traditional concept that the main important element for bowel control is the sphincter mechanism.

The authors present a classification of anorectal malformations, based on therapeutic and prognostic factors.


Fecal Incontinence Anal Canal Bladder Neck External Sphincter Internal Sphincter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Animation 2.1

Sphincter contraction in a normal human body (WMV 6049 kb)

Animation 2.2

Sphincter contraction in a perineal fistula (WMV 9281 kb)

Animation 2.3

Sphincter contraction in a rectourethral bulbar fistula (WMV 8929 kb)

Animation 2.4

Sphincter contraction in a prostatic fistula (WMV 9185 kb)

Animation 2.5

Sphincter contraction of a recto-bladder neck fistula (WMV 8865 kb)

Animation 2.6

Dynamic representation of the spectrum of anorectal malformations (WMV 10016 kb)


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Alberto Peña
    • 1
  • Andrea Bischoff
    • 1
  1. 1.Pediatric SurgeryColorectal Center for Children Cincinnati Children’s HospitalCincinnatiUSA

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