Presacral (retrorectal) tumors are particularly rare in the adult. There is difficulty in the performance of diagnostic biopsy, and specialized imaging is required to plan surgical extirpation. This review assesses their incidence and classification as well as the principles involved in their diagnosis and surgical management.

A larger prospective study of internal anal sphincter-preserving seton use in cryptogenic high transshincteric fistula-in-ano appears justified.

TPUS is a novel technique for use in perirectal infection which has a significant learning curve but which is highly accurate for prediction of the anatomy of complex recurrent as well as simple anal fistulae.