Anal Dilation

When a child is born with an anorectal malformation, surgical correction of that birth defect is followed by anal dilation in order to keep the anus open to a correct size for eliminating waste and not allow it to “heal” itself closed. Dilation is done with a tool called a Hegar dilator, which slowly stretches the anus in a process that should not cause pain. The procedure is done twice a day at the beginning, with the number of procedures diminishing over time. Because the dilation procedure must be repeated on a regular basis for quite some time, parents are taught how to perform it at home using disposable dilators. However, the procedure can be done at the hospital if need be. Each week, the size of the Hegar dilators increases until the appropriate anal diameter is reached. In all, the dilation schedule for children who have undergone Posterior Sagittal Anorectoplasty or a similar operation is approximately six months.