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Taking “Trans-ano-rectal” out of ASTRA: An anterior sagittal approach without splitting the rectum
Journal of Pediatric UrologyVol. 18Issue 1p96–97Published online: December 21, 2021- Kathy H. Huen
- Sarah A. Holzman
- Carol A. Davis-Dao
- Elias J. Wehbi
- Antoine E. Khoury
Cited in Scopus: 1The anterior sagittal trans-ano-rectal approach (ASTRA) provides excellent exposure to the urethra and vagina for partial or total urogenital sinus mobilization and subsequent reconstruction for patients with urogenital sinus anomalies. It is a frequent approach to reconstruction for children with a high confluence. However, the division of the anterior anal external sphincter and the rectal wall in the ASTRA incurs morbidity, which include fecal incontinence if one veers from the midline, and increased risk of wound infection due to fecal soilage.
