en Pediatric Pediatric Original Research: Clinical Science Original Research: Clinical Science <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">Anorectal malformations (ARMs) are congenital anomalies frequently associated with genitourinary abnormalities and other developmental defects. Surgical correction commonly involves colostomy, posterior sagittal anorectoplasty (PSARP), or laparoscopic/laparotomy-assisted approaches. This study aimed to evaluate the occurrence of neurogenic bladder and vesicoureteral reflux (VUR) in ARM patients and their associations with ARM type, fistula location, vertebral anomalies, and surgical technique.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> This cohort study included 173 children with ARM in the pediatric surgery department of Ali-Asghar Hospital, Iran, from July 2011 to July 2021. Data on genitourinary problems, including urinary tract infections, vesicoureteral reflux, and neurogenic bladder, were gathered from clinical records and follow-up visits.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> A total of 37 patients were diagnosed with neurogenic bladder and 44 with vesicoureteral reflux. This study stated higher occurrences of neurogenic bladder and reflux in patients who underwent PSARP. Neurogenic bladder was more prevalent in patients with high-type ARM and rectourethral fistula. The highest incidence of recurrent urinary tract infections was observed in boys with high-type ARM. Approximately 8% (14) of patients showed signs of kidney failure that led to chronic kidney failure.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion:</b> Statistical evaluation of genitourinary issues in patients with ARM who underwent surgery at our center underscores the importance of informing parents of the need for regular follow-up. Given that some of these issues may lead to delayed adverse effects on kidney function, early diagnosis and timely intervention are crucial for preventing complications and slowing the progression to kidney failure and end-stage renal disease (ESRD).</span></span></span></span></span></span></span></span><br> &nbsp; Anorectal Malformation, Postoperative Complications, Urinary Tract Infection, Vesicoureteral Reflux, Neurogenic Bladder 51 57 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-9802-1&slc_lang=en&sid=1 Fatemeh Abedi Karjiban abedi.k.fatemeh@gmail.com 200319475328460096292 0009-0003-8639-6834 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Fariba Jahangiri Jahanf89@gmail.com 200319475328460096293 200319475328460096293 Yes Department of Pediatric Surgery, Ali -Asghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mahmoud Salek amir.msalek@gmail.com 200319475328460096294 200319475328460096294 No Department of Pediatric Surgery, Ali -Asghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Tahereh Chavoshi chavoshi.t@iums.ac.ir 200319475328460096295 200319475328460096295 No Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Elham Zarei Zarei.e@iums.ac.ir 200319475328460096296 200319475328460096296 No Department of Radiology, Ali - Asghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mahdi Bassirian bassirian2012@gmail.com 200319475328460096297 200319475328460096297 No Department of Pediatric Surgery, Ali -Asghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran