Many of them expressed anxiety and confusion regarding this concept. It is true that many patients with anorectal malformations have associated vertebral, renal, esophageal or radial defects. However, it is our specific purpose to provide orientation to those parents of children with anorectal malformations, to redefine in their own minds what is important and unimpor tant for their children's future. It has no real, functional prognostic value and tends to complicate a very simple problem.
Anorectal malformations are a spectrum of defects.
This includes, on the good side of the spectrum, very simple defects with an excellent future functional prognosis for bowel control which requires, to be repaired, a small easy operation without a protective colostomy. At the other end of the spectrum, one can see extremely complex malformations which require a diverting colostomy at birth. In addition, they may require other kinds of urinary diversions. Their main repair represents a formidable challenge, a great deal of expertise, delicate and meticulous technique, many hours in the operating room, often several operations, and still the final functional results are far from p erfect. Parents with children who have anorectal malformations must concentrate their efforts in learning where in the spectrum their child's defect resides in order to try to predict what their child's quality of life is expected to be and to avoid the creation of false expectations.