Rectourethroperineal Fistula Associated with an Atretic Bulbomembranous Urethra: Successful Staged Management of a New Variant of an Extremely Rare Anorectal Malformation.

Since 2005, only one case of a male patient presenting with a congenital rectourethroperineal fistula was reported. It was classified as a rare regional variant of an H-type rectourethral fistula in Krickenbeck's anorectal malformations classification. A staged approach was used to manage the patient, including colostomy, anorectoplasty, and a hypospadias correction. We report a second case of a continent rectourethroperineal fistula with the rare association of an atretic bulbomembranous urethra. The patient underwent staged surgeries to separate the rectum and the urethra from the perineal fistula, reposition the neoanus, and anastomose the anterior-to-posterior urethral tracts. These resulted in fecal continence and successful voiding.