Health Library

Pull-Through (PSARVUP) Surgery, What to Expect After

What Is a PSARVUP? 

A posterior sagittal anorectal vaginal urethral plasty (PSARVUP) is a procedure done to correct a specific type of anorectal malformation called cloaca. Cloaca is a defect of the anus, vagina and urethra. It is present from birth.

It is vital that your child’s doctor figures out the exact type of cloaca before deciding on surgery. Your child will have a series of tests. These will look at their body structure (colorectal and urogenital) and see if there are any malformations.

Before the Surgery

• Children with some types of malformation need to go to the hospital the day before surgery for bowel prep.
• If your child does not need to go to the hospital the day before surgery, the nurse will call you 48 hours (2 days) before the surgery date. They will discuss:
• Rules about eating and drinking
• When you need to arrive at the hospital
• Talk with the doctor if your child takes any medicine. Do not give your child any medicine on the morning of surgery unless your child’s doctor tells you to.
• On the day of surgery, the health care team will make sure your child is ready for surgery.

After Surgery

• Your child will be in the hospital for several days after surgery.
• They will likely have mild pain from the incision. They will get medicine to help with their comfort.
• Your child may go to the Pediatric Intensive Care Unit (PICU) for 1-2 days after surgery to be watched. This is due to the length of the surgery.
• Your child may have a special tube to drain urine (pee) for 2-3 weeks after surgery.
• Your child may have antibiotic ointment put on the incision for a few days.

Two (2) to four (4) weeks after surgery, anal dilations will be started. This will keep the anus from getting narrow as it heals. Here are some things you need to know about this:

• A dilator (medical rod) is used to keep your child’s new anus from getting narrow.
• It is crucial for the family to follow the plan given to them.
• The surgeon will do the first dilator.
• The surgeon or nurse will teach you how to do the dilations.
• They are done two times each day – one time in the morning and one time in the evening, but make sure you follow the dilation plan given to you.
• If the dilation plan is not done right, your child may need more surgery

If your child has a colostomy, it can be surgically closed 8-12 weeks after PSARVUP.

When to Call Doctor

Call your child’s doctor if you notice any of these: 

• Bleeding from your child’s incision.
• No stool in colostomy bag or diaper for more than 24 hours (1 day)
• Fever (temperature over 100.4^°)
• Your child has not peed in their diaper or the toilet at least one time every 4-6 hours

Call the Colorectal Center if you notice any of these issues or if you have any questions or concerns: 513-636-3240.