Rectourethral Bulbar Fistula in Males
About 80 percent of the male patients with anorectal malformations have an abnormal communication between the rectum and the urinary tract called a rectourinary fistula. The specific location of the fistula has important therapeutic and prognostic implications.
In a rectourethral bulbar fistula the rectum communicates with the lower posterior portion of the urethra called bulbar.
Usually meconium can be detected in the urine by filtering through a gauze pad placed at the tip of the penis. This can be confirmed by urinalysis.
The passing of meconium through urine usually occurs after 16 to 24 hours of life, once enough intraluminal bowel pressure has developed to force the meconium through the fistula.
A colostomy is indicated followed by a definitive repair. The most common repair performed is the Posterior Sagittal Anorectoplasty / PSARP, which is performed on an elective basis usually within the first year of life.
For more information or to request an appointment, please contact the Colorectal Center at Cincinnati Children's.
