Patients with imperforate anus and a perineal, cutaneous fistula have the opening of the latter situated between external genitalia and the site of the external anal sphincter.
Perineal inspection reveals:
Repair in both sexes involves a minimal posterior sagittal anoplasty at 3-4 months of age. The rectum is partially dissected and then moved to the region of the external sphincter. The formation of a protective colostomy is not required.
Prognosis for return of function is excellent, but intermittent constipation remains a residual problem in most cases. It is treated prophylactically.
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