COMPREHENSIVE TREATMENT OF RECTOURETHRAL FISTULAS IN CHILDREN
Keywords:
Rectourethral fistula, anorectal malformations, surgical treatment, diagnosis, abdomino-perineal plasty, complications.Abstract
The study analyzes surgical treatment of rectourethral fistulas (RUF) in boys with anorectal malformations (ARM) at TashPMI (2009–2019). Among 246 boys with ARM, 52 (21.1%) had RUF (55.8% rectoprostatic, 42.3% rectobulbar). Diagnostics included ultrasound, CT, and intraoperative verification. In 57.7% of cases, high ARM forms were misdiagnosed initially, leading to suboptimal interventions. Main correction methods: abdominoperineal pull-through (BPPT) – 48.1%, perineal surgeries (7.7%). Complications (11.5%) included strictures, fistula recurrence, and wound infections. Mortality was 3.9% (2 cases). The optimal timing for radical correction was 4-6 months. BPPT proved effective for primary RUF, while perineal approaches were preferred for recurrent cases. The study highlights the importance of accurate diagnostics (urethrocystography, colostography) and surgical method selection based on fistula level and surgeon expertise. Results emphasize the need for specialized centers to reduce diagnostic errors and improve outcomes in complex ARM cases.
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