Lesions in the urinary tract may complicate surgery for ARM. Before the definitive repair, it is essential to minimize the risk of urinary tract infections caused by the rectourogenital connection, if present. This is best accomplished by establishing a completely diverting colostomy and by careful washout of the rectal pouch . Infection may cause permanent damage to the kidneys, because upper urinary tract anomalies, and especially vesicoureteral reflux, are common [13-15]. Infection may occur after definitive repair
and is caused in most cases by a urological anomaly, vesicoureteral reflux being the most common . Urinary infections may be caused by a rectourinary fistula remnant that is too long . Damage to the pelvic innervation and urethra during the dissection of rectal blind pouch may cause urinary incontinence or urethral stricture . The incidence of urological injuries associated with surgery are strongly related to the experience of the surgeon . A detailed imaging of the rectourinary communication by contrast studies may decrease the possibility of injury. Many of the functional urinary abnormalities previously attributed to surgical intervention are congenital [13,19].
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Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.