Total anorectal reconstruction following congenital anorectal anomaly: report of a case.

Following several unsuccessful postnatal attempts at anoplasty to correct anal atresia with a rectovaginal fistula, the patient, 20 years later, underwent an anorectal sphincteric construction using a gracilis-muscle transplant. The five-stage procedure, which extended over a period of two years, resulted in highly satisfactory continence and full social rehabilitation of the patient. The continence achieved in this case seems to be in contradiction to some of the accepted concepts of the mechanisms of continence.