Objective: Urogenital anomaly has been considered as the most common associated condition with anorectal malformation
(ARM). There were recommendations for urogenital anomaly surveillance. The goal of this study was to evaluate the benefit
of screening tools for urogenital anomalies in ARM patients, especially low type malformations, in our institution.
Material and Method: A retrospective review of 183 ARM patients in Siriraj Hospital between January 2004 and December
2014 was performed. Demographic data included age, sex, type of anorectal malformation, type of surgery, and other associated anomalies. Basic screening methods are ultrasonography and voiding cystourethrography. Further investigations included diuretic renogram, intravenous pyelography, radionuclide scan, magnetic resonance urography, cystoscopy, and retrograde pyelography. Symptoms, types of anomaly, and treatments of urinary tract anomaly were recorded.
Results: All 183 patients were reviewed. Low type malformation accounted for 51 patients. One hundred and fifty three were scheduled for renal ultrasonography as a screening protocol, in which 42 had abnormal results. The most common anomaly was vesicoureteric reflux followed by renal agenesis. Thirteen low-type ARM patients had abnormal screening results. After follow-up, 4 out of 11 hydronephrotic and pelviectatic patients appeared normal in later years. Hypospadias was the
predominated genital abnormality among low type ARM with urinary tract anomaly patients. This correlation was not found
in non-low type patients.
Conclusion: Hydronephrosis was the most common genitourinary abnormality in low type ARM, which some of them
spontaneously resolved. Expectant management was preserved in selected cases with normal kidney function. Noninvasive
screening tests should be encouraged and performed in all ARM patients regardless of the types.

Keywords: Anorectal malformation, Genitourinary abnormality