PSARP Posterior Sagittal Anorectoplasty

Posterior sagittal anorectoplasty is a new technique used to repair anorectal malformations. This plastic surgery is used to create a functunal anus and rectum in children with this malformation.

­Information on Anorectal Malformations

Knowing what anorectal malformations are can help people to understand why posterior sagittal anorectoplasty or PSARP is. This malformation is a birth defect that effects the development of the anus. This also can affect the urinary systems or the reproductive system and its structures. Defects of the heart, kidneys, limbs, spine, and esophagus have also been associated with PSARP. When being diagnosed this always determined to be present at birth with no anal opening or an abnormally placed anus. It is estimated that this occurs in 1 out of every 400 newborns.

The Surgery

This defect is either determined to be high or low. This determination will help doctors decide on what type of surgery is needed. A surgeon should explain the exact effects of the child’s particular malformation and why a particular surgery is recommended. The most common surgery that is performed in PSARP cases is when a smaller than normal anal opening needs to be stretched with dialators. This is a one stage surgical repair. This is the most common case with infants with a determined low defect. A common name for this procedure is anoplasty. In cases where an infant has been determined to have a high malformation than a colostomy is needed and has to be performed in the first 24 to 48 hours. The purpose of this is to allow the infant to pass stool through an opening called a "stoma". This allows the intestine of the infant to function normally. After this another procedure is planned within a few weeks. This surgery is called a PSARP. This separates the urinary and sexual structures from the anus. The colostomy will remain opened until healing from the PSARP is healed. After healing is complete the infant will return to the hospital to have the colostomy closed.

Planning

After the PSARP your infant will remain in the hospital for four or five days. Careful care is needed after this surgery is performed. Your doctor will go over this in detail. This care my include prescribed cream to prevent very serious diaper rash, a diet consisting of fruits, vegetables, and whole grains, baths with very mild soap, and Tylenol for pain.

Afterwards

The most common side effect of this surgery is constipation. Normal growth should be expected. Follow up care with your child’s pediatrician through their childhood is important. The pediatrician will need to monitor your child for any additional problem that may arise. Constipation control may be a necessary management needed through out your child’s life. Staying educated and keeping up with all medical appointments is the best practice in these situations.­



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last visit: PSARP Posterior Sagittal Anorectoplasty | Children with disabilities | Anorectal manometry test | Classification of Anorectal Malformation | ARM Anorectal malformation
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