The association of congenital anal stenosis, scimitar-shaped sacral defect and a 
presacral mass is known as the Currarino triad. These patients present with 
constipation of variable severity which may result from a combination of 
compression by the mass, neurogenic dysfunction as well as anal stenosis itself. 
We have treated three patients who illustrate the spectrum of severity of this 
condition. All had an associated tethered cord. One was cured by a single anal 
dilatation, cord release and anterior meningocele repair. The second did not 
improve after anoplasty and neurosurgical intervention. A previously diagnosed 
rectal ectasia was felt to be contributory to the constipation and was treated 
by low anterior resection with excellent results. The third patient developed an 
ischiorectal abscess that required drainage and colostomy after unsuccessful 
dilatation of a very tight and deeply scarred anal stenosis. A subsequent 
tethered cord release and closure of the anterior meningocele was followed by an 
anoplasty. Colostomy was closed at a later date. In all patients with anal 
stenosis a search should be made for a presacral mass and its associated sacral 
defect. Release of the tethered cord, resection of the presacral mass and/or 
closure of the anterior meningocele are essential for optimal functional 
results.