Imperforate Anus
Treatment

To treat imperforate anus, surgery will be performed to create an opening, or new anus, to allow stool to pass. The surgery may differ, depending on whether the anus ends high or low in the pelvis.

If the intestine ends high in the pelvis, treatment usually involves three procedures:

• In a procedure called a colostomy, a stoma — an opening on the abdomen where the intestine is brought out to the skin — is created. Stool passes out the opening into a special stoma bag worn on the outside of the body, on the abdomen.
• The second procedure, called anoplasty, involves pulling the rectum down to the anus where a new anal opening is created. If the child has a fistula connecting the intestine to the bladder or vagina, that connection will be closed.
• Several months later after the new anal opening has healed, a third procedure will be performed to close the stoma.

If the intestine ends low in the pelvis, an anal opening often can be made in a single operation. The rectum is pulled down to the anus and a new anal opening is created, using a minimally invasive technique called laparoscopy. In these cases, a stoma is not necessary.

If the anal opening is in the wrong position, it will be closed and moved to the correct location.

Following the operation, babies have very frequent bowel movements that can cause severe diaper rash. A protective skin cream is used immediately after surgery.

Babies can go home once they are drinking, having bowel movements, feeling comfortable on pain medication and are free of fever.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.
Last updated July 14, 2010