Urinary Incontinence in Males with Imperforate Anus
Most male patients who have surgery to repair an imperforate anus (a birth defect in which the anal canal fails to develop) preserve urinary control. The possible exception is males born without a sacrum, the lower part of the spine that forms part of the pelvis. Otherwise, male patients who are not able to control their bladder and urine flow following surgery suffered some sort of nerve or other damage as a result of the operation.
Among female patients, the outlook for urinary continence is not as certain because the problem could be a cloaca, a complex malformation which involves a fusion of rectal, vaginal, and urinary channels into a single common channel. In these cases, even patients with a well formed sacrum may require intermittent catheterization 70% of the time when the common channel is longer than 3 cm and 20% of the time when the common channel is shorter than 3cm. Cloaca patients suffer from a bladder malfunction that make them unable to empty their bladder. These patients, however, usually have a good bladder neck and therefore can remain completely dry with intermittent catheterization.
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