CCPR Continence Index  ::  Nationwide Children's Hospital

Predicting Continence in Children with Anorectal Malformations/Imperforate Anus

If your child has an anorectal malformation/imperforate anus, you know the basics. Your baby has no anal opening, so one needs to be surgically created. But you may wonder whether your child will have fecal continence (the ability to control bowel movements). Will the new anus work? Will your child be able be able to wear normal underwear?

At the Center for Colorectal and Pelvic Reconstruction at Nationwide Children’s Hospital, Surgical Director Marc Levitt, MD and his team have created an index to answer these questions. Substantial advances in the surgical treatment of anorectal malformations (ARM) have occurred in the last several decades. Improved techniques have resulted in a dramatic reduction in complications and better success with achieving continence.

 

Based on a patient’s anatomy, the Continence Predictor Index can help predict a child’s likelihood of being continent by the age of 3. For many children, it will allow doctors to make a prediction even in the first few days of life. 

Should you start to potty train your child at age 3? Or should you plan to participate in the bowel management program to achieve stool cleanliness?

At the Center for Colorectal and Pelvic Reconstruction, we evaluate the following factors to create an individualized score for your child’s potential for continence:  

  • Type of anorectal malformation
  • Type of spine
  • Type of sacrum 

With the development of the Continence Predictor Index, we feel that our ability to predict continence even prior to surgical intervention could be an important component in knowing what to expect for your child’s future. 

Newborn ARM patients typically undergo routine screenings, including a kidney ultrasound, spinal ultrasound and/or MRI, and x-rays of the sacrum. The ARM type is either diagnosed by clinical exam or demonstrated on a radiology study called a distal colostogram

For patients with good potential for future continence, potty training strategies and laxative treatment is used. For patients who are unlikely to achieve full continence, a bowel management program can be planned to successfully get them clean.

Every child is different. At the Center for Colorectal and Pelvic Reconstruction, we are happy to meet with your family to determine your child’s Continence Predictor Index and expectations for future continence. 

Our team would be happy to answer any questions or schedule an appointment at (614) 722-4086.

For a downloadable version (PDF) of the Continence Predictor Index Tool, click here.

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Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000