For mild imperforate anus defects the first step involves enlarging the opening where the stool drains, so stool can pass more easily. Surgery involves closing any small tube-like openings (fistulas), creating an anal opening, and putting the rectal pouch into the anal opening. Treatment to treat imperforate anus, surgery will be performed to create an opening, or new anus, to allow stool to pass. The surgery may differ, depending on whether the anus ends high or low in the pelvis. The treatment for imperforate anus depends on the specific type of abnormality, the severity of the problem, associated anomalies, and the overall health and medical history of your child. Childrens hospital of philadelphias pediatric colorectal program offers both medical and surgical therapies for the management of imperforate anus and other anorectal malformations. Backgroundpurpose the authors present their experience and results in the treatment of infants with imperforate anus over a 10-year period. Differences between these and previously published western results are noted and discussed. Methods one hundred eight patients with imperforate anus were treated from june 1988 to july 1998. To prevent the anus from narrowing, it may be necessary to stretch the anus periodically. Imperforate anus may also be part of a syndrome with multiple birth defects. Treatment may include colostomy and surgery to correct the defect. Prognosis depends on the severity and type of imperforate anus and the severity and type of any other birth defects.