104 -7 (81) 2025 - Bozorov Sh.T., Xaydarov A.B. - RECTO-UROGENITAL FISTULAS IN INFANTS WITH ANORECTAL MALFORMATIONS: EARLY DIAGNOSIS, SURGICAL TIMING, AND RISK OF URINARY COMPLICATIONS

RECTO-UROGENITAL FISTULAS IN INFANTS WITH ANORECTAL MALFORMATIONS: EARLY DIAGNOSIS, SURGICAL TIMING, AND RISK OF URINARY COMPLICATIONS

Bozorov Sh.T. - Andijan State Medical Institute

Xaydarov A.B. - Andijan State Medical Institute

Jo’rayev J.D. - Andijan State Medical Institute

Resume

To assess the impact of recto-urogenital fistulas in infants with anorectal malformations (ARMs), focusing on early diagnosis, optimal surgical timing, and the risk of urinary complications. We review diagnostic imaging strategies, surgical approaches, and post-operative urinary outcomes. A structured review of Scopus-indexed articles describing recto-urethral or recto-vestibular fistulas in newborns. Key outcomes include detection methods, timing of definitive repair, incidence of urinary sequelae, and bladder dysfunction over long-term follow-up. Database searches (Scopus, PubMed, Embase) included terms “anorectal malformation,” “recto-urethral fistula,” “recto-urogenital fistula,” and “urinary complications.” Studies reporting ≥10 patients, published 2005–2025, were included if they described diagnostic protocols, timing of surgery, and follow-up evaluation of urinary function. Narrative synthesis was used to collate findings on outcomes relevant to early infancy. Among ~12 eligible studies (covering >800 infants with ARMs), recto-urethral fistulas accounted for 50–70% of high or intermediate ARMs in males [1,2,6]. Early detection typically combined clinical inspection (e.g., dribbling of meconium from the urethra) with invertogram or cross-table lateral radiography. Surgical management strategies varied: 40–60% of centers used staged repair (colostomy first, definitive anorectoplasty later), while others pursued a primary posterior sagittal anorectoplasty (PSARP) in select stable neonates [3,6]. Reported urinary complications included vesicoureteral reflux (10–25%), recurrent urinary tract infections (up to 30%), hydronephrosis (5–10%), and mild to moderate bladder dysfunction (10–20%) [7,8]. Long-term data suggested higher risk of incontinence in patients with sacral dysplasia or high-level fistulas [3,8]. Early surgical correction (within 3–6 months) plus vigilant bladder surveillance reduced urologic morbidity. Recto-urogenital fistulas in ARMs require prompt recognition and multidisciplinary care. Timely diagnosis prevents renal compromise, while individualized surgical planning—whether single-stage or staged—optimizes anorectal and urinary outcomes. Close postoperative monitoring, including imaging of the urinary tract, is crucial to detect and manage complications such as vesicoureteral reflux or bladder dysfunction.

Keywords: Recto-urethral fistula, Anorectal malformation, Infants; Surgical timing, Urinary complications, Vesicoureteral reflux

First page

550

Last page

555

For citation:Bozorov Sh.T., Xaydarov A.B., Jo’rayev J.D. - RECTO-UROGENITAL FISTULAS IN INFANTS WITH ANORECTAL MALFORMATIONS: EARLY DIAGNOSIS, SURGICAL TIMING, AND RISK OF URINARY COMPLICATIONS//New Day in Medicine 7(81)2025 550-555 https://newdayworldmedicine.com/en/new_day_medicine/7-81-2025

List of References

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