J Korean Surg Soc.  2011 Jun;80(6):431-436. 10.4174/jkss.2011.80.6.431.

Clinical experience with persistent cloaca

• Cho MJ
• Kim TH
• Kim DY
• Kim SC
• Kim IK

• KMID: 2212189
• DOI: http://doi.org/10.4174/jkss.2011.80.6.431

Abstract

PURPOSE
Persistent cloaca is one of the most severe types of anorectal malformation. Appropriate initial drainage is difficult due to their various malformations and hydrocolpos or dilated urinary bladder. Corrective surgery also differs among individual patients. We describe our experiences with the surgical management of children with persistent cloaca.
METHODS
We retrospectively reviewed 16 children diagnosed with persistent cloaca at Asan Medical Center.
RESULTS
Sixteen patients were managed in their neonatal period. Twelve patients had enlarged bladder or vagina at birth. Three patients, who did not undergo cystostomy or vaginostomy at first operation, had earlier complications after surgery or required drainage tube insertion. One patient who did not undergo hydrocolpos drainage died of sepsis and complications. Nine patients underwent corrective surgery; posterior sagittal anorectovaginourethroplasty using the Pena method. Three patients required additional operations due to complications after surgery.
CONCLUSION
Patients found to have anatomical malformations before colostomy, as well as hydrocolpos and bladder enlargement, require a vaginostomy with or without a cystostomy to reduce complications. Follow-up is required in patients with hydrocolpos and bladder enlargement to determine whether vaginal drainage improves dilated bladder. Continuous long-term follow-up examination is required to determine the long-term results of corrective surgery.

Keyword

Persistent cloaca; Anorectal malformation; Hydrocolpos; Posterior sagittal anorectovaginourethroplasty

MeSH Terms

Anus, Imperforate
Child
Cloaca
Colostomy
Cystostomy
Drainage
Follow-Up Studies
Humans
Hydrocolpos
Parturition
Retrospective Studies
Sepsis
Urinary Bladder
Vagina
Anus, Imperforate

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