ArticleMedical journal of the Islamic Republic of Iran2026
Postoperative Genitourinary Challenges in Children with Anorectal Malformations: A Prospective Cohort Study Highlighting the Role of Follow-up.
Article in Medical journal of the Islamic Republic of Iran, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Anorectal malformations (ARMs) are congenital anomalies frequently associated with genitourinary abnormalities and other developmental defects. Surgical correction commonly involves colostomy, posterior sagittal anorectoplasty (PSARP), or laparoscopic/laparotomy-assisted approaches. This study aimed to evaluate the occurrence of neurogenic bladder and vesicoureteral reflux (VUR) in ARM patients and their associations with ARM type, fistula location, vertebral anomalies, and surgical technique. Methods: This cohort study included 173 children with ARM in the pediatric surgery department of Ali-Asghar Hospital, Iran, from July 2011 to July 2021. Data on genitourinary problems, including urinary tract infections, vesicoureteral reflux, and neurogenic bladder, were gathered from clinical records and follow-up visits. Results: A total of 37 patients were diagnosed with neurogenic bladder and 44 with vesicoureteral reflux. This study stated higher occurrences of neurogenic bladder and reflux in patients who underwent PSARP. Neurogenic bladder was more prevalent in patients with high-type ARM and rectourethral fistula. The highest incidence of recurrent urinary tract infections was observed in boys with high-type ARM. Approximately 8% (14) of patients showed signs of kidney failure that led to chronic kidney failure. Conclusion: Statistical evaluation of genitourinary issues in patients with ARM who underwent surgery at our center underscores the importance of informing parents of the need for regular follow-up. Given that some of these issues may lead to delayed adverse effects on kidney function, early diagnosis and timely intervention are crucial for preventing complications and slowing the progression to kidney failure and end-stage renal disease (ESRD).
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