PSARP — Anorectal Malformation Repair
Creating an anal opening in the correct position, within the muscles.
What is PSARP — Anorectal Malformation Repair?
The definitive repair for an anorectal malformation. The bowel is brought down and placed precisely within the muscles that provide continence, and an anal opening is created in the correct position.
Hospital stay
About a week per stage.
Performed by
Dr. Pratheep Samraj
- Normal
- The problem
Why It Is Done
Surgery is advised in these situations. The decision is always made after examining your child, never from a description.
- To create a bowel opening in the right place, within the sphincter muscles
- To close any abnormal connection to the urinary tract or vagina
- To give the best achievable chance of bowel control
Before the Day
- Most children have had a colostomy formed in the newborn period
- A distal colostogram defines the exact anatomy and any fistula
- The spine, kidneys and heart are assessed, since associated conditions are common
During the Operation
- General anaesthetic, usually at a few months of age
- The bowel is mobilised and placed within the muscle complex, guided by a nerve stimulator
- Any fistula to the urinary tract or vagina is divided and closed
Afterwards, and at Home
- About a week or more in hospital
- Anal dilatations begin after a couple of weeks and parents are taught to continue them at home
- The colostomy is closed at a later operation once the new anus is comfortably open
- Bowel management — diet, laxatives or enemas — is a normal part of care, not a sign of failure
What Can Go Wrong
- Narrowing of the new anus if dilatations are not kept up
- Wound infection or breakdown
- Recurrence of a fistula, which is uncommon
- Continence varying with the type of malformation and the shape of the sacrum
Every operation carries risk. These are listed openly because a parent consenting to surgery is entitled to know them — not because they are expected. The surgeon will go through which of them actually apply to your child.
Common Questions
If your question is not here, send it on WhatsApp and the hospital team will answer.
Dr. Pratheep Samraj
Consultant Paediatric & Neonatal Surgeon · Palliyadi, Kanyakumari
Super-specialist surgical care for newborns, infants and children, with expertise in paediatric urology, congenital anomalies, gastro-intestinal surgery and minimally invasive surgery.
Related Pages
The aim is not just an opening, but an opening in the right place inside the muscle.
That is what decides continence years later, which is why the position matters more than the timing. Bring the newborn records and any colostomy details.
Consultation 10:00 AM - 1:00 PM & 4:00 PM - 8:00 PM · 24-hour laboratory & pharmacy
In an emergency — green vomiting in a baby, a groin swelling that will not go back, severe tummy pain, or a newborn not passing urine or meconium — come straight to the hospital or to your nearest emergency department. Do not wait for a reply to a message.