urorectal

Urorectal refers to structures, conditions, and processes involving both the urinary tract and the rectum. In anatomy and embryology, the term is often used in the context of the pelvis where the urinary and digestive tracts are in close proximity, and in clinical discussions of fistulas and malformations that affect both systems.

During embryogenesis, a common cavity called the cloaca is partitioned by the urorectal septum into a ventral urogenital sinus and a dorsal anorectal canal. Improper development of this separation can lead to urorectal anomalies, such as persistent cloaca in females, or fistulous connections between the urinary and intestinal tracts (urorectal fistulas).

Urorectal fistulas are abnormal communications that allow urine and fecal matter to mix, presenting with fecaluria or pneumaturia, recurrent infections, and incontinence. They can be congenital, associated with anorectal malformations, or result from trauma, infection, or surgical complications.

Evaluation uses pelvic imaging (MRI, CT, fistulography), endoscopy, and urinary studies. Management is usually multidisciplinary and may involve staged surgical repair to separate the tracts, restore continence and function, and correct associated anorectal malformations. Techniques include posterior sagittal anorectoplasty for anorectal malformations and fistula repair with tissue interposition when appropriate.

See also: cloaca, anorectal malformations, fistula, urogenital development.