What is Pull-Through (PSARP) Surgery?
What Is a PSARP?
A posterior sagital anorectoplasty (PSARP), sometimes called a pull-through surgery, is a procedure that repairs anorectal malformations, or defects of the rectum and/or anus. Children can be born with many kinds of malformations. Your child’s doctor will do an exam on your child and review a series of test to figure out the type of defect. Then they will discuss the best treatment plan for your child. This will often include 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.
- Your child will be in the hospital for several days after surgery.
- They will likely have mild pain from the incision. A plan will be made to help with their comfort.
- Your child may have a special tube to drain urine (pee) from the bladder for a few days after surgery.
- We will teach you how to care for your child’s incision.
- A dilator (medical rod) is used to help 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. You will do these once in the morning and once in the evening.
- 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 closed by surgery about 8-12 weeks after PSARP.
When to Call the Doctor
Call your child’s doctor at the Colorectal Center if you notice:
- Bleeding from your child’s incision or area of the surgery.
- Fever (temperature over 100.4° F).
- There is no stool (poop) in the colostomy bag or your child has not pooped in their diaper for more than 24 hours (1 day).
- Your child has not peed in their diaper or the toilet at least one time every 4-6 hours.
Call the Colorectal Center at 513-636-3240 if you notice any of these issues or if you have any questions or concerns.