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Rectovaginal Separation Operation After a Cutback Procedure for Anorectal Anomalies

Rectovaginal Separation Operation After a Cutback Procedure for Anorectal Anomalies Abstract The "cutback" procedure has been widely utilized over the past 25 years for correction of mild forms of ectopic anus encountered in newborn females. As these children have become adolescents, some are troubled by the cosmetic appearance created by this procedure, recurrent urinary tract infections, and persistent vaginitis from continued fecal soiling. The rectovaginal separation procedure described (1) separates the rectum from the vagina by interposing adjacent tissues, (2) elongates the rectal canal, and (3) utilizes flaps of perineal skin to gain a normal degree of separation of the anus from the vagina. Five girls, ages 6 to 15 years, have undergone this procedure with a temporary loop colostomy to protect the perineum during healing. The long-term functional and cosmetic results three to seven years later have been excellent in four patients. The fifth girl has been observed only five months, but seems to have an excellent cosmetic result. References 1. Browne D: Some congenital deformities of the rectum, anus, vagina and urethra . Ann R Coll Surg Engl 8:173-192, 1951. 2. Warren JC: A new method of operation for the relief of rupture of the perineum through the sphincter and rectum . Tr Am Gynecol Soc 72:322-336, 1882. 3. Bryndorf J, Madsen CM: Ectopic anus in the female . Acta Chir Scand 118:466-478, 1960. 4. Stephens FD, Smith ED: Ano-rectal Malformations in Children . Chicago, Year Book Medical Publishers Inc, 1971. 5. Potts WJ, Riker WL, DeBoer A: Imperforate anus with recto-vesical, recto-urethral, recto-vaginal and recto-perineal fistula . Ann Surg 140:381-395, 1954.Crossref 6. Rhoads JE, Koop CE: Symposium on function and disease of anorectum and colon . Surg Clin North Am 35:1251-1257, 1955. 7. Trusler GA, Wilkinson RH: Imperforate anus: A review of 147 cases . Can J Surg 5:269-277, 1962. 8. Santulli TV, Schullinger JN, Amoury RA, et al: Malformations of the anus and rectum . Surg Clin North Am 45:1253-1271, 1965. 9. Nixon HH, Callaghan RP: Ano-rectal anomalies: Physiology in considerations . Arch Dis Child 39:158-160, 1964.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Rectovaginal Separation Operation After a Cutback Procedure for Anorectal Anomalies

Burrington, John D.
Archives of Surgery , Volume 110 (5) – May 1, 1975
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References (11)

Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360110017004
Publisher site
See Article on Publisher Site

Abstract

Abstract The "cutback" procedure has been widely utilized over the past 25 years for correction of mild forms of ectopic anus encountered in newborn females. As these children have become adolescents, some are troubled by the cosmetic appearance created by this procedure, recurrent urinary tract infections, and persistent vaginitis from continued fecal soiling. The rectovaginal separation procedure described (1) separates the rectum from the vagina by interposing adjacent tissues, (2) elongates the rectal canal, and (3) utilizes flaps of perineal skin to gain a normal degree of separation of the anus from the vagina. Five girls, ages 6 to 15 years, have undergone this procedure with a temporary loop colostomy to protect the perineum during healing. The long-term functional and cosmetic results three to seven years later have been excellent in four patients. The fifth girl has been observed only five months, but seems to have an excellent cosmetic result. References 1. Browne D: Some congenital deformities of the rectum, anus, vagina and urethra . Ann R Coll Surg Engl 8:173-192, 1951. 2. Warren JC: A new method of operation for the relief of rupture of the perineum through the sphincter and rectum . Tr Am Gynecol Soc 72:322-336, 1882. 3. Bryndorf J, Madsen CM: Ectopic anus in the female . Acta Chir Scand 118:466-478, 1960. 4. Stephens FD, Smith ED: Ano-rectal Malformations in Children . Chicago, Year Book Medical Publishers Inc, 1971. 5. Potts WJ, Riker WL, DeBoer A: Imperforate anus with recto-vesical, recto-urethral, recto-vaginal and recto-perineal fistula . Ann Surg 140:381-395, 1954.Crossref 6. Rhoads JE, Koop CE: Symposium on function and disease of anorectum and colon . Surg Clin North Am 35:1251-1257, 1955. 7. Trusler GA, Wilkinson RH: Imperforate anus: A review of 147 cases . Can J Surg 5:269-277, 1962. 8. Santulli TV, Schullinger JN, Amoury RA, et al: Malformations of the anus and rectum . Surg Clin North Am 45:1253-1271, 1965. 9. Nixon HH, Callaghan RP: Ano-rectal anomalies: Physiology in considerations . Arch Dis Child 39:158-160, 1964.Crossref

Journal

Archives of Surgery – American Medical Association

Published: May 1, 1975

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