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Surgery on Children

Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Original Article
Safety and benefits of early urethral catheter removal after resectioning the recto urethral fistula during posterior sagittal anorectoplasty
Abstract
Aims: A urethral catheter must be placed before PSARP (Posterior Sagittal Anorectoplasty) is performed on boys with recto-urethral fistula. However, there is no agreement on when the catheter should be removed. Surgeons usually keep the catheter for more than weeks, which is uncomfortable for patients. This study assesses the advantages and safety of removing the catheter early after PSARP.
Methods: We have divided the patents into two groups. In Group 1, patients underwent PSARP with resection of RUF from January 2017 to February 2021, and the urethral catheter was kept for 14 days. In Group 2, patients were operated on between March 2021 and July 2023, and the urethral catheter was removed on the second day after the operation. The two groups ' demographic and clinical variables were compared using SPSS version 26. Outcome variables were post-operative urinary retention, difficulty in micturition, catheter blockage or dislodgement, fistula recurrence, hospital stay duration, and antibiotic therapy duration.
Results: No patients in either group had urinary retention, recurrence of fistula, or lower urinary complication. However, postoperative hospital stay and antibiotic therapy significantly reduced from 11.2±2.3 days in Group 1 to 4.1±0.5 days in Group 2 (p<0.01).
Conclusion: Early catheter removal after PSARP is safe, improves patient comfort, and reduces unnecessary hospital stays and antibiotic therapy.

Keywords : Anorectal malformation, recto urethral fistula, posterior sagittal anorectoplasty, urethral catheterization

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1. Cassina M, Fascetti Leon F, Ruol M, et al. Prevalence and survival ofpatients with anorectalmalformations: A population-based study. JPediatr Surg. 2019;54:1998-2003. doi:10.1016/j.jpedsurg.2019.03.004
2. Pe&ntilde;a A, Devries PA. Posterior sagittal anorectoplasty: importanttechnical considerations andnew applications. J Pediatr Surg.1982;17:796-811. doi: 10.1016/s0022-3468(82)80448-x
3. Huang Y, Xu W, Xie H, et al. Cystoscopic-assisted excision ofrectourethral fistulas in maleswith anorectal malformations. J PediatrSurg. 2015;50:1415-1417. doi:10.1016/j.jpedsurg.2015.04.002
4. Stenstr&ouml;m P, Anderberg M, Kockum CC, et al. Endoscopically placedrectourethral guidewirefacilitates the reconstruction of anus inchildren with anorectal malformations: a case report.European JPediatr Surg Rep. 2013;1:46-47. doi: 10.1055/s-0033-13451044
5. Al Matar Z, Maqbool S, Zakaria H, et al. Simple division ofrectourethral fistula as analternative to ligation during laparoscopicrepair of anorectal malformation. Ann Pediatr Surg. 2022:18(1):1-4.https://doi.org/10.1186/s43159-022-00225-9
6. Ming AX, Li L, Diao M, et al. Long term outcomes of laparoscopic-assisted anorectoplasty: acomparison study with posterior sagittalanorectoplasty. J Pediatr Surg. 2014;49:560-563. doi:10.1016/j.jpedsurg.2013.11.060
7. Zaiem M, Zaiem F. Muscle complex saving posterior sagittalanorectoplasty. J Pediatr Surg. 2017;52:889-892. doi: 10.1016/j.jpedsurg.2016.12.013
8. Pandey V, Gangopadhyay AN, Gupta DK, et al. Management ofanorectal malformation without ligation of fistula: an approachpreventing posterior urethral diverticula. J Pediatr Urol. 2014;10:1149-1152. doi: 10.1016/j.jpurol.2014.04.016
9. Jadhav S, Raut A, Mandke J, et al. Nonclosure of rectourethral fistuladuring posterior sagittal anorectoplasty: our experience. J Indian AssocPediatr Surg. 2013;18:5-6. doi: 10.4103/0971-9261
10. Nagdeve NG, Bhingare PD, Naik HR. Neonatal posterior sagittalanorectoplasty for a subset of males with high anorectal malformations.J Indian Assoc Pediatr Surg. 2011;16:126-128. doi:10.4103/0971-9261.86863
11. Kulshrestha S, Kulshrestha M, Yadav A, et al. Posterior sagittalapproach for repair of rectourethral fistula occurring after perinealsurgery for imperforated anus at birth. J Pediatr Surg. 2000;35:1155-1160. doi: 10.1053/jpsu.2000.8717
12. Beiske MJ, Veiby Holm H, Nilsen OJ. A comparison of urethralcatheterization duration -three weeks versus two weeks after bulbarurethroplasty. Scand J Urol. 2021;55:313-316. doi:10.1080/21681805.2021.1945141
13. Durrani SN, Khan S, Ur Rehman A. Transurethral resection of prostate:early versus delayedremoval of catheter. J Ayub Med Coll Abbottabad.2014;26:38-41.
14. Lepor H, Nieder AM, Fraiman MC. Early removal of urinary cathetersafter radical retropubic prostatectomy is both feasible and desirable.Urology. 2001;58:425-429. doi: 10.1016/s0090-4295(01)01218-3
15. Chua M, Welsh C, Amir B, et al. Non-stented versus stentedurethroplasty for distal hypospadias repair: A systematic reviewand meta-analysis. J Pediatr Urol. 2018;14:212-9.doi: 10.1016/j.jpurol.2017.11.023
16. Almusafer M, Abduljabbar OH, Buchholz N. Stented versus non-stented snodgrassurethroplasty for distal hypospadia repair. Urol Int.2020;104:156-159. doi: 10.1159/000503887
17. Snodgrass W, Grimsby G, Bush NC. Coronal fistula repair under theglans without reoperative hypospadias glansplasty or urinary diversion.J Pediatr Urol. 2015;11:39.e1-4. doi:10.1016/j.jpurol.2014.09.007
18. Hasan MS, Islam MN, Mahmud R, et al. Complete separation ofthe urinary tract from proximal rectum during PSARP surgery:our experience with the novel technique. World J Pediatr Surg.2024;7:e000688. doi: 10.1136/wjps-2023-000688
19. Pe&ntilde;a A, Hong AR, Midulla P, et al. Reoperative surgery for anorectalanomalies. Semin Pediatr Surg. 2003;12:118-123. doi: 10.1016/s1055-8586(02)00022-7
20. Hong AR, Acu&ntilde;a MF, Pe&ntilde;a A, et al. Urologic injuries associated withthe repair of anorectal malformations in male patients. J Pediatr Surg.2002;37:339-44. doi:10.1053/jpsu.2002.30810
21. Arunachalam P, Sen S, Sam CJ, et al. Pathology and surgicalmanagement of urinary retention manifesting after anorectalmalformation surgery. J Indian Assoc Pediatr Surg. 2022; 27:147-52. doi:10.4103/jiaps.JIAPS_348_20
22. Nagdeve NG, Bhingare PD, Naik HR. Neonatal posterior sagittalanorectoplasty for a subset of males with high anorectal malformations.J Indian Assoc Pediatr Surg. 2011;16:126-128. doi:10.4103/0971-9261.86863
23. Pelizzo G, Canonica CPM, Destro F, et al. Anorectal malformations:ideal surgery timing to reduce incontinence and optimize QoL.Children (Basel). 2023;10(2):404. doi: 10.3390/children10020404
Article available in :
Volume 1, Issue 3, 2024
Page : 49-51
https://doi.org/10.51271/SOC-0013
Article Information
Received : 12 Ağu 2024
Accepted : 18 Eyl 2024
Published : 30 Eyl 2024
Corresponding Author :

Samiul Hasan: Department of Pediatric Surgery, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh

[email protected]
Citation : Hasan S, Islam N, Mahmud R, Rahman A. Safety and benefits of early urethral catheter removal after resectioning the recto urethral fistula during posterior sagittal anorectoplasty. Surg Child. 2024;1(3):49-51.

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