PMID- 33896617
OWN - NLM
STAT- MEDLINE
DCOM- 20211129
LR  - 20211129
IS  - 1531-5037 (Electronic)
IS  - 0022-3468 (Linking)
VI  - 56
IP  - 12
DP  - 2021 Dec
TI  - Conservative management of anterior located anus: A medium-long term follow up.
PG  - 2277-2280
LID - S0022-3468(21)00297-9 [pii]
LID - 10.1016/j.jpedsurg.2021.04.003 [doi]
AB  - BACKGROUND/PURPOSE: The anterior anus (AA) is a condition, almost exclusively 
      present in females, in which the anus is located abnormally anterior along the 
      perineal body, well separated from the vulva. Definition and treatment are still 
      controversial. This study aimed to evaluate the medium-long term follow up of 
      patients with AA conservatively managed, considering the gynaecologic aspects in 
      post-menarchal girls. MATHERIALS/METHODS: This cross-sectional study includes AA 
      patients older than 3 years at time of the study, followed in two referral 
      centres for ARM between January 2000 and May 2017. The API (Anal Position Index) 
      was applied to define AA. A questionnaire regarding the ano-rectal function, 
      occurrence of urinary infection (UTI), familiarity for ARM/AA was administered to 
      parents and patients. Gynecological examination was performed in post-menarchal 
      patients. RESULTS: Fifty-three patients (all females) were retrieved. Three were 
      excluded (2 underwent surgery at another center, 1 was lost at follow-up), 7/50 
      had major malformations (2 oesophageal atresia, 4 cardiovascular malformations 
      and 1 with Fallot, uretheral duplicity and vertebral anomalies), 5/50 had 
      familiarity for ARM/AA. Only 10% were constipated. Fifteen patients underwent 
      gynecological examination. Their mean API was 0.278 +/- 0.013 DS, they had good 
      buttock tropism, normal resident bacteria, and no UTI. CONCLUSION: AA patients in 
      our centers do not undergo any kind of surgery. At least three quarters of them 
      have a perfectly normal bowel habits and adolescents do not present symptoms 
      related to their condition. These results support the conservative management of 
      this condition.
CI  - Copyright (c) 2021. Published by Elsevier Inc.
FAU - Duci, Miriam
AU  - Duci M
AD  - Pediatric Surgery Division, Women's and Children's Health Dept, University of 
      Padua, Padua, Italy.
FAU - Fascetti-Leon, Francesco
AU  - Fascetti-Leon F
AD  - Pediatric Surgery Division, Women's and Children's Health Dept, University of 
      Padua, Padua, Italy.
FAU - Bogana, Gianna
AU  - Bogana G
AD  - Gynecology&Obstetrics Unit, Women's and Children's Health Dept, Padua, Italy.
FAU - Gamba, Piergiorgio
AU  - Gamba P
AD  - Pediatric Surgery Division, Women's and Children's Health Dept, University of 
      Padua, Padua, Italy.
FAU - Midrio, Paola
AU  - Midrio P
AD  - Pediatric Surgery Unit, 'Ospedale Ca' Foncello', Treviso, Italy. Electronic 
      address: paola.midrio@aulss2.veneto.it.
LA  - eng
PT  - Journal Article
DEP - 20210420
PL  - United States
TA  - J Pediatr Surg
JT  - Journal of pediatric surgery
JID - 0052631
SB  - IM
MH  - Adolescent
MH  - *Anal Canal/surgery
MH  - *Conservative Treatment
MH  - Constipation
MH  - Cross-Sectional Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
OTO - NOTNLM
OT  - Anterior located anus
OT  - Bowel function
OT  - Conservative management
OT  - Lower urinary tract
COIS- Declaration of Competing Interest All authors declare no conflict of interest.
EDAT- 2021/04/27 06:00
MHDA- 2021/11/30 06:00
CRDT- 2021/04/26 05:34
PHST- 2020/12/20 00:00 [received]
PHST- 2021/03/21 00:00 [revised]
PHST- 2021/04/01 00:00 [accepted]
PHST- 2021/04/27 06:00 [pubmed]
PHST- 2021/11/30 06:00 [medline]
PHST- 2021/04/26 05:34 [entrez]
AID - S0022-3468(21)00297-9 [pii]
AID - 10.1016/j.jpedsurg.2021.04.003 [doi]
PST - ppublish
SO  - J Pediatr Surg. 2021 Dec;56(12):2277-2280. doi: 10.1016/j.jpedsurg.2021.04.003. 
      Epub 2021 Apr 20.