{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T22:09:53Z","timestamp":1784153393567,"version":"3.55.0"},"reference-count":14,"publisher":null,"issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Constipation is a common problem after surgery for anorectal malformations (ARMs), especially in patients having preserved rectosigmoid after pull-down surgery. Here, we present our experience with patients having constipation after surgery for ARMs and briefly discuss its management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed electronic operative and follow-up data from January 2015 to December 2019 of all patients having constipation after surgery for ARMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 77 patients were included in the study. The median age was 60 months, and thirty patients were male. Primary diagnoses were rectourethral fistula (26; 33.77%), vestibular fistula (25; 32.47%), perineal fistula\/ectopic anus (18; 23.38%), rectovaginal fistula (4; 5.19%) and imperforate anus without fistula (4; 5.19%). Anal stenosis was found in 20 (25.97%) patients, posterior ledge with an adequate anal opening in 5 (6.49%), displaced anus in 4 (5.19%) but no obvious problem found in 48 (62.34%) patients. Non-operative management was successful in 75.44% (43 out of 57) of patients. Surgery was performed in 32 out of 77 patients (41.56%) with no mortality. Forty-three (72.88%) patients are continent, stayed clean, but 16 (27.19%) patients still need some sort of laxative\/bowel wash\/enema intermittently (Grade I\/II constipation). Incidence of constipation was higher in patients operated through anterior sagittal route (27.58%) than posterior sagittal route (23.94%), but it was not statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.479). Follow-up ranged from 3 months to 5 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Constipation is a common problem after ARMs surgery, especially in patients having preserved rectosigmoid after pull-down surgery. It is advisable to create relatively larger neoanus after pull through with early practice of neoanus dilatation, especially in redo cases. Repeated counselling, laxatives and dietary manipulations should begin at the first sign of constipation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ajps.ajps_63_20","type":"journal-article","created":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T05:36:44Z","timestamp":1613453804000},"page":"67-71","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Constipation after Surgery for Anorectal Malformations"],"prefix":"10.67481","volume":"18","author":[{"given":"Vijai D.","family":"Upadhyaya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laxmi K.","family":"Bharti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwani","family":"Mishra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd.","family":"Yousuf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhakar","family":"Mishra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basant","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":null,"reference":[{"key":"R1-15-20240829","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/S0022-3468(96)90661-2","article-title":"The anterior sagittal approach for high imperforate anus: A simplification of the Mollard approach","volume":"31","author":"Sigalet","year":"1996","journal-title":"J Pediatr Surg"},{"key":"R3-15-20240829","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1016\/j.jpedsurg.2010.02.096","article-title":"The morbidity of constipation in patients with anorectal malformations","volume":"45","author":"Levitt","year":"2010","journal-title":"J Pediatr Surg"},{"key":"R4-15-20240829","first-page":"35","article-title":"Anorectal malformations","volume":"4","author":"Pe\u00f1a","year":"1995","journal-title":"Semin Pediatr Surg"},{"key":"R5-15-20240829","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0022-3468(98)90380-3","article-title":"Bowel management for fecal incontinence in patients with anorectal malformations","volume":"33","author":"Pe\u00f1a","year":"1998","journal-title":"J Pediatr Surg"},{"key":"R6-15-20240829","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jpedsurg.2006.10.034","article-title":"Reoperations in anorectal malformations","volume":"42","author":"Pe\u00f1a","year":"2007","journal-title":"J Pediatr Surg"},{"key":"R7-15-20240829","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/S1055-8586(02)00022-7","article-title":"Reoperative surgery for anorectal anomalies","volume":"12","author":"Pe\u00f1a","year":"2003","journal-title":"Semin Pediatr Surg"},{"key":"R8-15-20240829","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/S0022-3468(05)80275-1","article-title":"Megasigmoid: A source of pseudoincontinence in children with repaired anorectal malformations","volume":"28","author":"Pe\u00f1a","year":"1993","journal-title":"J Pediatr Surg"},{"key":"R9-15-20240829","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/j.jpedsurg.2005.08.002","article-title":"Preliminary report on the international conference for the development of standards for the treatment of anorectal malformations","volume":"40","author":"Holschneider","year":"2005","journal-title":"J Pediatr Surg"},{"key":"R10-15-20240829","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/0016-5085(93)90166-A","article-title":"Chronic constipation in children","volume":"105","author":"Loening-Baucke","year":"1993","journal-title":"Gastroenterol"},{"key":"R11-15-20240829","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/S0022-3468(96)90241-9","article-title":"Anterior sagittal anorectoplasty for anorectal malformations and perineal trauma in the female child","volume":"31","author":"Wakhlu","year":"1996","journal-title":"J Pediatr Surg"},{"key":"R12-15-20240829","doi-asserted-by":"crossref","first-page":"S64","DOI":"10.5489\/cuaj.4411","article-title":"Bladder and bowel dysfunction in children: An update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem","volume":"11","author":"Santos","year":"2017","journal-title":"Can Urol Assoc J"},{"key":"R13-15-20240829","doi-asserted-by":"crossref","first-page":"148","DOI":"10.4103\/jiaps.JIAPS_140_17","article-title":"Revision surgery in the management of anorectal malformations: Experience from a tertiary center of India","volume":"23","author":"Kumar","year":"2018","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R14-15-20240829","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1016\/j.jpedsurg.2008.03.047","article-title":"Single-stage repair of vestibular and perineal fistulae without colostomy","volume":"43","author":"Kumar","year":"2008","journal-title":"J Pediatr Surg"},{"key":"R15-15-20240829","doi-asserted-by":"crossref","first-page":"166","DOI":"10.4103\/0189-6725.99409","article-title":"Anorectal malformation coexisting with Hirschsprung's disease: A report of two patients","volume":"9","author":"Lukong","year":"2012","journal-title":"Afr J Paediatr Surg"}],"container-title":["African Journal of Paediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ajps.AJPS_63_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:49:14Z","timestamp":1782953354000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/ajps.AJPS_63_20"}},"subtitle":["Unrecognised Problem until It is a Problem"],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ajps.ajps_63_20","relation":{},"ISSN":["0189-6725"],"issn-type":[{"value":"0189-6725","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}