Urologic implications of anorectal malformations.

The urologist has assumed a major role in the management of the child with imperforate anus. Fistulas from the rectum to the urinary tract, as well as associated genitourinary anomalies such as vesicoureteral reflux, make the urologist an important member of the team managing imperforate anus. Special spheres of urologic interest occur immediately (when accurate imaging is important), during the first year (when urinary tract infections and acidosis may occur), and in later childhood and adolescence (when the management of neurogenic bladder or complications of previous repairs of the anorectal anomaly are important).