title: Fecal and urinary continence after scope-assisted anorectovaginoplasty for female anorectal malformation.
abstract: OBJECTIVE
  We assessed continence after scope-assisted anorectovaginoplasty (SARVP) for female anorectal malformation (FARM).
  
  
  METHODS
  Five FARM cases were assessed; cases 1 and 2: cloacal malformation; case 3: urogenital sinus, and rectovestibular fistula (RF); case 4: RF, absent vagina, and sacral anomaly; case 5: covered cloacal exstrophy. Treatment was SARVP in all cases, with perineal vaginoplasty (case 1), vagina pull-through (PT) similar to Georgeson's colon PT (case 2), and the use of the native RF/cloaca channel as a vagina (cases 3-5). Continence was assessed pre and postoperatively.
  
  
  RESULTS
  SARVP was performed in the lithotomy position without repositioning. Mean age at surgery was 3.2 (1.7-5.5) years. Current mean age: 8.8 years (range 7.5-12.2). Mean follow-up: 5.7 years. Preoperative continence: fecal: all had stomas; urinary: cases 1 and 2: continent; cases 3-5: incontinent. Postoperative continence: fecal: cases 1-3: continent; case 4: incontinent; case 5: awaiting stoma closure; urinary: cases 1 and 2: continent; cases 3 and 4: incontinent; case 5: continent (intermittent catheterization). Fetal continence evaluation questionnaire (CEQ) scores for cases 1-4 were 7.5, 9, 10, and 2 (maximum score 10, mean 7.1).
  
  
  CONCLUSIONS
  Scope assistance improves visualization, thus pelvic sphincter dissection/division is minimized with less detrimental impact on postoperative continence.
authors.affiliation: Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. yama@juntendo.ac.jp
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
authors.forename: Shumpei
authors.initials: S
authors.lastname: Goto
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koga
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Lane
authors.forename: Tadaharu
authors.initials: T
authors.lastname: Okazaki
mesh_terms: D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery; D002648:Child; D003672:Defecation / Q000502:physiology*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D012007:Rectum / Q000002:abnormalities* / Q000601:surgery; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000503:physiopathology / Q000601:surgery; D014554:Urination / Q000502:physiology*; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery