Abstract
We describe five boys, all of whom presented with urinary tract infection or acquired urinary incontinence some years after surgery for a high anorectal malformation (ARM). All were found to have a posterior urethral diverticulum thought to represent the remains of the original rectourethral fistula accompanying the high rectal atresia. Excision of the diverticula resulted in complete relief of symptoms. The clinical features and radiological appearances of the diverticula are described. A urethral diverticulum is one treatable cause of urinary symptoms in children with high anorectal malformations, and should be considered when symptoms recur late after definitive surgical correction of the malformation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gross GW, Wolfson PJ, Pena A (1991) Augmented-pressure colostogram in imperforate anus with fistula. Pediatr Radiol 21:560–562
Parrot TS (1985) Urologic implication, of anorectal malformations. Urol Clin North Am 12:13–21
Partridge JP, Gough MH (1961) Congenital abnormalities of the anus and rectum. Br J Surg 49:37–50
Williams DI, Grant J (1969) Urological implications of imperforate anus. Br J Urol 41:660–665
Pena A (1993) Management of anorectal malformations during the newborn period. World J Surg 17:385–392
Boyd SD, Raz S (1993) Ectopic ureter presenting in midline urethral diverticulum. Urology 41:571–574
Preminger GM, Steinhardt GF (1985) Male urethral diverticulum: the double density sign. Urology 26:417–419
Laudone VP, Green KF, Wyker AW (1988) Giant posterior urethral diverticulum after radical retropubic prostatectomy. J Urol 139:364–366
Currarino G (1969) Diverticulum of prostatic urethra developing postoperatively from stump of congenital rectourethral fistula. Am J Roentgenol 106:211–215
Persky L, Tucker A, Izant RJ (1974) Urological complications of correction of imperforate anus. J Urol 111:415–418
Shashikumar VL, Cresson SL (1974) Urethral diverticulum: complication of abdominoperineal pull-through procedure. J Pediatr Surg 9:249–250
Rintala R, Lindahl H, Sariola H, Rapola J, Louhimo I (1990) The rectourogenital connection in anorectal malformations is an ectopic anal canal. J Pediatr Surg 25:665–668
de Vries PA, Dorairajan T, Guttman FM, Kottmeier PK, del Campo NM, Nixon HH, Pena A, Smith ED, Stephens FD, Yokoyama J (1988) Operative management of high and intermediate anomalies in males. Birth Defects 24:317–401
Soave F (1969) Surgery of rectal anomalies with preservation of the relationship between the colonic muscle sleeve and the puborectalis muscle. J Pediatr Surg 4:705–712
Smith ED, Stephens FD (1988) High, intermediate and low anomalies in the male. Birth Defects 24:17–72
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vinnicombe, S.J., Good, C.D. & Hall, C.M. Posterior urethral diverticula: a complication of surgery for high anorectal malformations. Pediatr Radiol 26, 120–126 (1996). https://doi.org/10.1007/BF01372089
Issue Date:
DOI: https://doi.org/10.1007/BF01372089