ABSTRACT
This chapter discusses Anorectal malformation and soiling. It describes the case study of a 5-year-old boy, who is assessed for fecal incontinence. He was born with an anorectal malformation and a rectourethral fistula. He was managed initially with a colostomy, then underwent a primary posterior sagittal anorectoplasty (PSARP) at 1 year of age, and the colostomy has since been reversed. This child has a good potential for bowel control. His sacral ratio is 0.71 and he has a normal spine. His self-confidence will be much improved by being clean on enemas for several months. The patient returned for a redo PSARP to improve the anatomy and the potential for continence. He also has a Malone appendicostomy fashioned to allow antegrade administration of the same enema regimen and, when more mature, he may succeed with a laxative trial.
