For deep proctatresia, postoperative aftercare consisting of adequate, long-term bougienage is important. On the basis of 10 cases, it was shown that inadequate postoperative bougienage for proctatresia leads to formation of a megacolon and to overflow incontinence. The incontinence can then only be controlled by carrying out a proctectomy and a sigmoidectomy together with surgical formation of the gracilis. This proved to be satisfactory for all 10 cases presented.