Primary perineal rectovaginoanoplasty for supralevator imperforate anus in female neonates.

Sixteen girls (including 12 neonates), all of whom had supralevator anorectal anomalies usually with a high rectovaginal fistula, were treated by a primary rectovaginoanoplasty. None of these patients had any opening onto the perineum or into the vestibule. Through the perineum, with a dissection behind the vagina, the rectum was freed of any fistulous attachment and brought through the puborectalis sling to the perineum. Of the 12 patients now aged 2-years and over, 11 can control solid stools, and three soil with diarrhea only. The operation is easier than other available procedures, and the complications were minimal.