title: German network for congenital uro-rectal malformations: first evaluation and interpretation of postoperative urological complications in anorectal malformations.
abstract: OBJECTIVE
  The aim of the German Network for Congenital Uro-REctal Malformations is to collect data of affected patients with anorectal malformation (ARM) or extrophy-epispadias complex, and to investigate molecular causes, clinical implications, and psychosocial outcome. The current issue was to assess the postoperative sequelae related to lower urinary tract dysfunction in patients with ARM.
  
  
  METHODS
  Two hundred and sixty-seven patients with ARM (112 females, 155 males, median age 6 years, range 0-56 years) were investigated via standardized case report forms comprising interview, analysis of medical data, and personal questionnaires.
  
  
  RESULTS
  Thirty-two patients (12%, 23 males, 9 females) suffered from neurogenic bladder dysfunction, mainly associated with recto-urethral fistula (11 cases, 34%), and recto-vesical fistula (6 cases, 19%). Sixty-eight patients (26%, 35 males, 57 females) have experienced lifetime urinary tract infection, primarily associated with recto-urethral fistula (21 cases, 31%), and vestibular fistula (13 cases, 19%). According to type of operation, the highest number of postoperative urologic problems was reported after abdominosacroperineal pull-through.
  
  
  CONCLUSIONS
  Besides reconstructing the ARM, another main goal is the preservation of lower urinary tract function. In our data, there seems to be a close correlation between operative strategies and postoperative complications.
authors.affiliation: Department of Pediatric Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany. stefanie.maerzheuser@charite.de
authors.forename: Stefanie
authors.initials: S
authors.lastname: Maerzheuser
authors.forename: Ekkehart
authors.initials: E
authors.lastname: Jenetzky
authors.forename: Nadine
authors.initials: N
authors.lastname: Zwink
authors.forename: Heiko
authors.initials: H
authors.lastname: Reutter
authors.forename: Enrika
authors.initials: E
authors.lastname: Bartels
authors.forename: Sabine
authors.initials: S
authors.lastname: Grasshoff-Derr
authors.forename: Stefan
authors.initials: S
authors.lastname: Holland-Cunz
authors.forename: Stuart
authors.initials: S
authors.lastname: Hosie
authors.forename: Eberhard
authors.initials: E
authors.lastname: Schmiedeke
authors.forename: Nicole
authors.initials: N
authors.lastname: Schwarzer
authors.forename: Nicole
authors.initials: N
authors.lastname: Spychalski
authors.forename: Gabriel
authors.initials: G
authors.lastname: Goetz
authors.forename: Dominik
authors.initials: D
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000002:abnormalities*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004065:Digestive System Abnormalities / Q000601:surgery; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D012003:Rectal Fistula / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D012007:Rectum / Q000002:abnormalities*; D014522:Urethral Diseases / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D014548:Urinary Fistula / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D014570:Urologic Diseases / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery