ABSTRACT
This chapter presents a case study of a newborn male infant with an anorectal malformation seen at 26 hours of age. He has undergone his routine VACTERL screening as per the protocol. In this patient there is a rectourethral fistula and the colon needs to be separated from the urinary tract. The raised area (skin tag) marks the center of the sphincter complex and the anoplasty should be centered here. It is somewhat anterior, and close to the scrotum, typical of a bladder neck or prostatic fistula. A mucous fistula is required to perform the distal colostogram in order to identify the level of the site of the fistula (e.g., rectobulbar or rectoprostatic). A loop colostomy should be avoided because fecal material can potentially spill into the mucous fistula.
