WOFAPS 2025 8th World Congress of Pediatric Surgery

Vijai Datta Upadhyaya, Pooja Prajapati, Rahul Goel

SGPGIMS, Lucknow India

Background: Vestibular fistula is the commonest anorectal malformation (ARM) in the female child. This study aimed to share our experience with modified technique of Posterior sagittal anorectoplasty (PSARP) for treatment for vestibular fistula

Method: In the period between January 2019-June 2024,Twenty patients of vestibular fistula admitted after the neonatal age. All were treated with PSARP without opening the fourchette. The results were evaluated for anal continence and cosmetic appearance. Median follow-up was 22 months (range12-48 months).

Result: A total of 20 patients were included in the study. Operative time ranges from 80 to 160 minutes. Post operative appearance of the perineum was satisfactory in all patients except minor superficial wound infection in 20% cases which was managed conservatively. Anal continence was good in 80%% cases and fair in 10% cases. Around 20% percent of patients had minimal constipation and 10% patients had minor mucosal prolapse.

Frequency of daily stool was 3-4 times in follow up.There was no recurrence of fistula or anterior displacement of the neorectum.

Conclusion: In our experience Primary PSARP for vestibular anus without opening fourchette has a good cosmetic appearance and comparable outcome with standard PSARP.