[Urodynamic investigations of bladder disturbances in imperforate anus and Hirschsprung's disease) (author's transl)].

104 children with imperforate anus and 68 children with megacolon congenitum were subjected to careful analysis in respect of postoperative incontinence of urine. This was observed in 20 patients with imperforate anus (19.2%) and 15 patients with Hirschsprung's disease (22%). In children with imperforate anus urine incontinence showed a slight tendency only to spontaneous cure. For example, 19.1% of the children with imperforate anus still showed signs of incontinence 11 years after the first operation. On the other hand, there was often a spontaneous cure of incontinence of urine in children with Hirschsprung's disease, so that 5.8% only of the patients had incontinence after the same period. The causes of incontinence are of a multifactorial nature. Rectourethral fistulas, which can damage the sphincter vesicae externus, play an important part. This is likewise true of sequel operations in the pelvis minor with iatrogenic lesions of the sacral nerve fibres; of associate malformations of the urogenital tract and of the vertebral column; and of chronic relapsing infections of the urinary tract caused by an accompanying encopresis (incontinence of faeces).