Single-stage operation without temporary colostomy for persistent cloaca with a short common channel.

Area of Science:

• Pediatric Surgery
• Neonatology
• Urology

Background:

• Persistent cloaca is a rare congenital anomaly requiring surgical correction.
• Definitive surgical repair often necessitates a temporary colostomy for fecal diversion.
• Minimizing surgical interventions in neonates is a key goal in pediatric care.

Observation:

• Two female infants diagnosed with persistent cloaca underwent rectal catheterization for stool evacuation.
• A silicone balloon-tipped catheter was placed under fluoroscopic guidance, allowing continuous stool drainage.
• Infants received home-based bowel irrigation, maintaining comfort and preventing complications.

Findings:

• Colorectal decompression with a catheter was successful in evacuating stool in both patients.
• No abdominal distension, colorectal dilatation, or urinary tract infections were observed during catheter use.
• Both infants achieved spontaneous voiding postoperatively without urological issues.

Implications:

• Catheter-based colorectal decompression may be a safe and effective alternative to colostomy in select infants with persistent cloaca.
• This approach is particularly suitable for cases with cloacal length < 3 cm and normal urinary tract function.
• Avoiding colostomy can lead to improved patient outcomes and reduced healthcare burden.