Postoperative manometric profile in recto-vestibular fistula and rectourethral fistula: A comparative study

Aims: The recto-urethral (RUF) and recto-vestibular fistula (RVF) are varieties of anorectal malformation (ARM) with distinct clinical behaviour. In this study post-operative clinico-manometric comparison has been done. Materials and Methods: The study was conducted for 2 year period and included post-operative cases of RUF and RVF. Post-operative follow up was done clinically and by anal manometry. Statistical analysis used: Kruskal Wallis test, Mann Whitney U test, and Spearman correlation test were done to find out the statistical significance. Results: A total of 21 patients with RUF and RVF were included. The average basal and squeeze pressure of RVF group was (cm H2O) 34.66 13.2 and 89.35 30.8 respectively. These pressures were higher than those of RUF which were 26.74 12.8 and 71.20 42.8 respectively. Rectoanal inhibitory reflex (RAIR) was present in 84.6% cases of RVF in comparison to 62.5% in RUF group. The mean combined (RUF + RVF) basal pressure in RAIR positive group was 32.97 12.2 compared to 24.5 4.6 cm H2O in RAIR negative group. The mean combined squeeze pressure in RAIR positive group was 84.34 36.2 compared to 68.83 32.75 cm H2O in RAIR negative group. Conclusions: The anal pressures of RVF group were higher than RUF group. Anal pressures also higher in RAIR positive group than the RAIR negative group. Anal pressures and RAIR status may have some role in post-operative outcome in cases of ARM. Keywords: Anorectal malformation, Anal manometry, RAIR in anorectal malformation, Recto-urethral fistula, Vestibular fistula.