쇄항 환아에 동반된 비뇨생식기의 기형

Abstract

The increased occurrence of genitourinary tract anomalies in infants with imperforate anus is well documented. A retrospective analysis was made on 130 children with imperforate anus over the last 10 years. A 21%(27cases) incidence of associated genitourinary anomalies was found in this series. Patients with high and intermediate imperforate anus demonstrated a 30%(19/61) incidence of genitourinary anomalies. In contrast, patients with low imperforate anus revealed 12% (8/66) incidence of genitourinary anomalies. The spectrum of these anomalies were hydronephrosis. bilateral renal agenesis, bilateral polycystic kidney, bilateral VUR, unilateral renal hypoplasia, posterior urethral stricture, renal stone, cryptorchidism, hypospadias and epispadias in descending frequency of order. Hydronephrosis (13/27, 48%) was the most frequently encountered anomaly. Patients with high imperforate anus seems to be prone to have more severe urinary anomalies. Fistulae between the rectum and urinary tract were found in 33 patients with high and intermediate type imperforate anus (rectourethral fistula; 27 cases, rectovesical fistula, 3 cases, rectocloacal fistula, 3 cases). During the posterior sagittal anorectoplasty, fistula was corrected simultaneously. In conclusion, early urological screening should be done for the early diagnosis and treatment of associated genitourinary anomalies in all children with imperforate anus. Key word : Imperforate anus, Genitourinary anomalies