J.Jpn. Surg. Soc.. 126(4): 347-353, 2025

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Feature topic

TRANSITION OF ANORECTAL MALFORMATION

Anorectal malformations include imperforate anus (low, intermediate, high) and cloacal malformations (persistent cloaca, cloacal exstrophy). Various types of surgical treatment and multidisciplinary care are necessary over the long term.
Bowel function is evaluated from the perspectives of management methods, voluntary bowel movement, constipation, fecal incontinence, and soiling. In cases of cloacal malformations, permanent colostomy management may sometimes be necessary.
Urinary function may be affected by posterior urethral diverticulum, recurrent rectourethral fistula, neurogenic bladder, urinary incontinence, and progressive renal dysfunction as postoperative complications, which have a significant impact on the quality of life.
Reproductive function in men can be affected by associated conditions such as hypospadias and undescended testicles, as well as erectile dysfunction and ejaculation disorders as postoperative complications, while in women, vaginal and uterine malformations can cause menstrual disorders and ovarian failure. Common problems include impaired sexual intercourse, problems with fertility, and gender identity disorder.
In addition, support is required from multiple angles for problems with the spine and nervous system, as well as mental and social problems.
Recently, there has been an active movement to collaborate on these issues at academic conferences, in group research, and under government initiatives together with patients.

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