Presentation of two cases of imperforate anus managed in infancy. In first case, at age of 19, surgical closure of recto-urethral fistula associated to excision of a rectal pouch complicated with infected lithiasis and renal damage provides definitive therapy. In second case, recto-urethral fistula was well tolerated for more than 50 years without renal damage. Simple removal of a prostatic lithiasis partially obstructing fistula, provided fair good result. Etiology of these fistulae, well known in pediatric patients, is then discussed. Management must be adapted to complaints and risks.
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