Medical Q&As

Imperforate anus - problems at puberty?

My 10-year-old daughter was born with an imperforate anus. She came through the surgery very well and is thriving and healthy. However, she needs to have an enema every other night in order to empty her bowels. My question is will she develop problems as puberty approaches?

Imperforate anus is a congenital abnormality of the rectum and anus. Affected children either have no anal opening or a very small fistula that allows only limited evacuation of the bowel. A fistula is a small tube-like opening that connects the bowel to the surface of the skin. Complete absence of an anal opening requires emergency surgery on the newborn child. It is sometimes necessary to perform a colostomy on such infants. The more complex anal repair is then performed some months later when the infant has grown further. One of the great challenges with this surgery is to repair the defect and also to ensure that the child has adequate bowel control. Despite the complexity of the surgery most of these congenital defects can be repaired. The long-term prognosis for these children is excellent. I assume that your daughter does not have any other congenital abnormalities therefore I would not anticipate any particular problems that she might encounter as she enters puberty.