**9. Complications**

Postoperative complications may include tenesmus, fecal incontinence, wound dehiscence, stricture of the anoplasty, colonic atony or megacolon and rectal prolapse (Suess et al., 1992; Prassinos et al., 2003; Vian & Tobias, 2005; Rahal et al., 2007; Ellison & Papazoglou, 2011). Fecal incontinence, a common complication after surgery, may be transient (Prassinos et al., 2003; Viana & Tobias, 2005, Rahal et al., 2007), intermittent or permanent (Suess et al., 1992; Ellison & Papazoglou, 2011) and related to a congenital absence of functional external anal sphincter or surgical trauma to the sphincter muscle innervation during dissection (Aronson, 2003; Prassinos et al., 2003; Viana & Tobias, 2005; Ellison & Papazoglou, 2011). Fecal incontinence secondary to surgical intervention in dogs may resolve several weeks to a year after surgery (Prassinos et al., 2003; Viana & Tobias, 2005; Rahal et al., 2007). Semitendinosus muscle flap application was proposed as an option to improve anal tone in a dog with atresia ani and rectovaginal fistula (Chambers & Rawlings, 1991). Wound dehiscence may be related to tension on the anastomosis and fecal contamination of the surgical site (Suess et al., 1992) and may be prevented by meticulous surgical technique. Stricure of the anoplasty site and fecal retention associated with colonic atony or megacolon are two common complications requiring a second surgery such as revision anoplasty, subtotal colectomy or colotomy (Viana & Tobias, 2005, Ellison & Papazoglou, 2011). Animals with stricture of the anoplasty site may develop tenesmus, constipation and fecal impaction. This complication may need a revision anoplasty or baloon dilatation to resolve. In a recent study with 12 cases of dogs and cats with atresia ani having surgical management, 5 animals with type II-III atresia ani, 4 of which combined with rectovaginal fistula, developed postoperative stricture and had initially balloon dilatation, which failed in all but one case.

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Of these failures 5 had revision anoplasty which was successful in 4 animals and 3 had concurrent colotomy for fecal impaction removal, all with good results (Ellison & Papazoglou 2011). Subtotal colectomy that was performed in one dog with type II atresia ani 2 weeks after anoplasty continued to show constipation associated with megacolon 9 months after surgery (Viana & Tobias, 2005). Colotomy or subtotal colectomy might be performed at the same time with anoplasty to help improve colonic function in animals with colonic dilatation or megacolon.
