CLINICAL COURSE AND DIAGNOSTIC APPROACHES OF ANORECTAL MALFORMATIONS ASSOCIATED WITH RECTOURETHRAL FISTULAS IN BOYS

Abstract

Introduction.Rectourethral fistulas represent one of the most complex and diagnostically challenging forms of anorectal malformations in boys. To evaluate the clinical course and diagnostic approaches in boys with anorectal malformations associated with rectourethral fistulas. A retrospective and prospective study was conducted on 504 patients with anorectal malformations treated between 2012 and 2022. Among them, 246 were boys. Patients with confirmed rectourethral fistulas were analyzed using clinical assessment, contrast radiological studies, urethrocystography, endoscopic methods, and methylene blue testing. Rectourethral fistulas were frequently associated with delayed diagnosis due to poor expression of classical clinical signs. Prostatic variants were more common and more difficult to detect than bulbar types. Diagnostic errors led to inappropriate surgical tactics and, in some cases, to iatrogenic fistulas. Accurate diagnosis of rectourethral fistulas requires a comprehensive diagnostic approach combining clinical and instrumental methods. Early identification of anatomical relationships between the rectum and urethra is crucial for improving surgical outcomes.