Anorectal Malformations: New Aspects Relevant to Adult Colorectal Surgeons

Posterior sagittal anorectoplasty as the preferred operative repair of high imperforate anus was first performed in 1980 by the author of this article, who is generally regarded as one of the pioneers in the development of this approach to a challenging and relatively infrequent congenital abnormality. Those who have undergone this operation as infants and progressed to adulthood are prone to problems with both incontinence and refractory constipation. This article describes the author's unique experience with the evaluation and treatment of these vexing problems should they occur in the adult population.