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Pediatric Surgery International

, Volume 35, Issue 2, pp 221–226 | Cite as

Tethered cord in children with anorectal malformations with emphasis on rectobladder neck fistula

  • I. SamukEmail author
  • A. Bischoff
  • E. Freud
  • A. Pena
Original Article

Abstract

Purpose

To find the incidence of tethered cord (TC) in patients with anorectal malformations (ARM) and to determine the relationship between bowel/urinary control and TC in a subset of patients with rectobladder neck fistula (RBNF).

Methods

The database of a tertiary medical center was retrospectively collected for all patients treated for ARM from 1980 to 2012. All patients with TC and RBNF were identified.

Results

Among 790 patients, who underwent screening for TC, 285(36%) were diagnosed with TC. Eleven of 37 screened patients with RBNF were diagnosed with TC. The median follow-up period was 49 months (range 2–222 months). TC was diagnosed in 3/18(16.6%) patients with sacral ratio (SR) ≥ 0.7; 4/12(33.3%) with SR 0.41–0.69; and 4/7(57.1%) patients with SR 0–0.4. The association of TC in RBNF patients had a negative influence in the prognosis for bowel and urinary control.

Conclusion

The incidence of TC among patients with ARM is 36%. Incidence of TC among patients with RBNF correlates with SR value and is higher with lower SR. Patients with RBNF and TC have dismal prognosis for bowel control, unrelated to their SR status. Many unresolved questions related to the management of ARM patients with asymptomatic TC still remain.

Keywords

Anorectal malformations Imperforate anus Tethered cord Rectobladder neck fistula 

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric and Adolescent Surgery, Schneider Children’s Medical Center, Petach Tikva, Affiliated with the Sackler Faculty of MedicineUniversity of Tel AvivTel AvivIsrael
  2. 2.International Center for Colorectal CareChildren’s Hospital ColoradoAuroraUSA

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