(ARMs) are congenital defects occurring in 1 of every 5,000 live births, where the rectum and anus don’t develop properly. These complex conditions require specialized surgical correction and lifelong management.
At Travel For Med, we connect families with world-renowned pediatric surgeons at JCI-accredited children’s hospitals who perform 200+ ARM repairs annually with exceptional outcomes.
Classification of Anorectal Malformations
By Gender & Anatomical Features
Male ARM Types
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Rectourethral fistula (most common male type)
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Rectovesical fistula
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Imperforate anus without fistula
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Anal stenosis
Female ARM Types
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Rectovestibular fistula (most common female type)
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Rectovaginal fistula
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Cloacal malformation (complex)
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Perineal fistula
By Complexity Level
| Type | Characteristics | Surgical Approach |
|---|---|---|
| Low | Well-developed muscles | Single-stage repair |
| Intermediate | Fistula present | Often two-stage |
| High | Poor muscles, complex fistula | Colostomy then repair |
Diagnostic Process for ARMs
Essential Evaluations
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Physical Exam:
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Perineal inspection
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Anal dimple/crease assessment
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Meconium presence/location
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Imaging Studies:
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Invertogram (newborn assessment)
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Pelvic MRI (gold standard for muscle evaluation)
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Distal colostogram (for fistula visualization)
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Associated Anomaly Screening:
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VACTERL (vertebral, cardiac, tracheoesophageal, renal, limb)
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Sacral anomalies (x-ray/MRI)
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Spinal cord evaluation (ultrasound)
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Surgical Treatment Approaches
Primary Repair Techniques
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PSARP (Posterior Sagittal Anorectoplasty)
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Gold standard for most ARMs
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85-90% continence outcomes
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LAARP (Laparoscopic-Assisted ARP)
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For high/intermediate malformations
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Reduced abdominal adhesions
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Staged Approach for Complex Cases
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Newborn Colostomy
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Diverts stool
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Allows growth before repair
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Definitive Repair (3-6 months)
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Fistula separation
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Anorectal reconstruction
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Colostomy Closure (4-6 weeks post-repair)
Long-Term Outcomes & Management
Functional Results by ARM Type
| Malformation Type | Bowel Control Rate | Urinary Control Rate |
|---|---|---|
| Perineal fistula | 95% | 98% |
| Rectourethral bulbar | 85% | 95% |
| Rectovestibular | 80% | 97% |
| Cloaca <3cm | 70% | 90% |
| Cloaca >3cm | 40% | 75% |
Ongoing Care Requirements
✔ Bowel management program (diet, enemas)
✔ Annual rectal exams
✔ Urodynamic studies
✔ Pelvic floor therapy
Why Choose Travel For Med for ARM Treatment?
Our partner hospitals offer:
✔ 3D pelvic MRI reconstruction
✔ Intraoperative neuromonitoring
✔ Laparoscopic/robotic options
✔ Multidisciplinary clinics
Cost Comparison of ARM Repair:
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USA: $85,000-$120,000
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UK: £65,000-£90,000
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Turkey: $18,000-$25,000 (same expertise)
Begin Your Child’s Treatment Journey
We provide:
✔ Free medical record review
✔ Second opinions from ARM specialists
✔ Travel/logistics coordination
✔ Follow-up care planning
Get world-class ARM care:
Contact Travel For Med Today
