Children's Hospital Colorado

Colorectal Procedures and Treatments

Where comprehensive care, personalized attention and world-class experience meet to treat patients with complex colorectal disorders.



Our dedicated team of doctors, nurses and physician assistants make up the most experienced colorectal and urogenital program in the world. We treat kids from our local communities in Colorado, the entire Rocky Mountain region, across the country and from overseas. Our Center supports, educates and counsels, while also providing surgical options and management techniques for patients dealing with bowel and/or genitourinary problems.

Colorectal surgery at the International Center for Colorectal and Urogenital Care

Our treatment approach to colorectal and urogenital conditions includes:

Pull-through procedure (PSARP)

Alberto Peña, MD, our internationally renowned pediatric colorectal surgeon, transformed colorectal treatment by introducing the posterior sagittal anorectoplasty (PSARP), also known as the "Peña pull-through procedure." This method is widely used by top surgeons all over the world to treat anorectal malformations (also known as imperforate anus) and has since been adapted to treat multiple conditions. These conditions include:

    • urogenital sinus
    • presacral masses
    • acquired recto-urethral fistulas
    • recto-vaginal fistulas
    • vaginal atresia
    • reoperations for Hirschsprung disease and other urogenital anomalies

Dr. Peña also introduced the posterior sagittal anorectal vaginal urethroplasty (PSARVUP) and several surgical maneuvers to reconstruct cloaca, a condition present at birth.

Antegrade continence enema (ACE) procedure

The antegrade continence enema (ACE) procedure (also called a Malone procedure) is a surgical procedure in which the surgeon uses your child's appendix or small piece of intestine to create a tube through which an enema is given. This provides an alternative option for children who need long-term enema therapy, but who do not want to have daily enemas given through the rectum.

We also offer a neo-appendicostomy for children whose appendix has been previously removed or used for a Mitrofanoff. The neo-appendicostomy is a procedure in which the surgeon creates a special flap from the colon to give enemas.

Other colorectal treatment options we offer

Our team of colorectal and urogenital experts understands that no two patients are alike. That's why we tailor treatment to your child's specific condition and needs. In our colorectal center, we offer services that include:

Enema administration

For patients with ongoing bowel challenges, a daily home-administered enema may be needed. We work with patients and families to understand how to administer enemas at home.

Bowel management

During our six-day outpatient program, we help patients with fecal incontinence due to anorectal malformations, Hirschsprung disease, spina bifida, sacrococcygeal teratoma and other conditions. Our goal is to find the right enema solution that will allow for better bowel control when given once a day.

We also help patients with constipation with or without encopresis to find the right dosage of laxatives to help with daily bowel movements.


Following the PSARP procedure, patients will need to follow a dilation protocol schedule to help prevent the natural healing process that occurs after surgery. The natural healing process causes an anal stricture or narrowing of the anus. We provide the dilation schedule and ongoing support for parents and patients as they work through this process.

Prenatal consultations

Whether you're pregnant and your child has been diagnosed with a colorectal condition or you're a woman with a colorectal condition trying to get pregnant, we're here to help.

Delivery support for women with colorectal conditions

Our experts understand how complex delivery can be with a colorectal condition or previous repair. We can help expectant mothers with these conditions deliver in a safe environment and advise on the mode of delivery.

Pediatric-to-adult care transition support

Patients with these conditions often have lifelong care needs. That's why we support them as they continue to age into adulthood, ensuring continuity of care as they grow.

Psychological support

Our clinical psychologist offers support for families and patients who are struggling with the personal, social, psychological and even financial impacts of colorectal conditions. We also offer a parent support group that meets every month at Children's Colorado's Anschutz Medical Campus in Aurora. Please contact us at 720-777-9880 for more information.

Why choose Children's Colorado for colorectal procedures and treatment?

Not only are we one of the only programs of this kind in the world, but we have world-renowned experts on staff. Dr. Alberto Peña and Andrea Bischoff, MD have performed thousands of colorectal surgeries, helping children with anorectal malformations, cloaca, cloacal exstrophy and more.

Because our staff includes some of the best trained and most experienced professionals, our International Center for Colorectal and Urogenital Care provides exceptional outcomes for our patients. Our Center also offers one-of-a-kind support for children, teens and young adults with a range of colorectal and urogenital conditions, ensuring that they get the lifetime of care they need and deserve.

Get to know our pediatric experts.

Andrea Bischoff, MD

Andrea Bischoff, MD

Surgery - Pediatric

Luis De La Torre-Mondragon, MD

Luis De La Torre-Mondragon, MD

Surgery - Pediatric

Duncan Wilcox, MD

Duncan Wilcox, MD

Urology - Pediatric

Veronica Alaniz, MD

Veronica Alaniz, MD

Ob/Gyn Obstetrics & Gynecology