Anterior sagittal transrectal approach (ASTRA) for vaginoplasty after complications of posterior sagittal anorectoplasty.

Transperineal exposure of the high portion of the vagina is limited. These limitations can be circumvented using ASTRA (anterior sagittal transrectal approach). We report the use of this surgical strategy for the treatment of a case of acquired vaginal atresia after posterior anorectoplasty due to anorectal malformation.