Andrea Bischoff, M.D., with Children's Hospital Colorado, describes the anatomic variations of cloaca and the different surgical maneuvers that are required for successful reconstruction of each type. Cloaca is a condition in which the urethra, vagina, and rectum are fused together as a common channel that opens as a single perineal orifice.

To support the medical education of colorectal and urogenital providers, Alberto Peña, M.D., with Children's Hospital Colorado, describes the now universally accepted surgical method that he developed for treating anorectal malformations. Posterior sagittal anorectoplasty (PSARP) surgery involves a number of steps. PSARP, also known as the Peña Pull-Through Procedure, transformed the surgical treatment of anorectal malformations.

Internationally renowned pediatric colorectal surgeon, Dr. Alberto Peña, explains why the first 24 hours of life for a newborn with an anorectal malformation are critical. Diagnostic information and associated medical management decisions made during this period can have significant health consequences and may greatly impact the baby’s prognosis.

Before 1980, surgeons were performing colorectal malformation surgeries “blind,” according to Alberto Peña, M.D. The limited surgical approach used at the time led to poor bowel and urinary functional outcomes and other serious complications.