Related Experiment Video
Updated: May 27, 2026
Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice
Published on: July 12, 2018
Clinical experience with persistent cloaca
Min-Jeng Cho1, Tae-Hoon Kim, Dae-Yeon Kim
1Department of Pediatric Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Insights
Persistent cloaca management in children requires initial drainage, often including vaginostomy or cystostomy, to prevent complications. Long-term follow-up is crucial for assessing surgical outcomes in these complex anorectal malformations.
Area of Science:
- Pediatric Surgery
- Congenital Malformations
- Anorectal Malformations
Background:
- Persistent cloaca is a severe anorectal malformation presenting significant surgical challenges.
- Management is complicated by associated hydrocolpos and/or dilated urinary bladder.
- Surgical approaches vary due to the complex and individualized nature of the malformations.
Purpose of the Study:
- To describe surgical management experiences in children with persistent cloaca.
- To highlight the importance of appropriate initial drainage strategies.
- To evaluate outcomes and complications associated with surgical interventions.
Main Methods:
- Retrospective review of 16 children diagnosed with persistent cloaca.
- Analysis of initial management, including drainage procedures (cystostomy, vaginostomy).
- Review of corrective surgical procedures, primarily posterior sagittal anorectovaginourethroplasty (PSARP).
Main Results:
- Twelve of 16 patients presented with enlarged bladder or vagina at birth.
- Failure to perform initial drainage (vaginostomy/cystostomy) was associated with earlier complications or need for drainage tube insertion.
- One patient without hydrocolpos drainage died from sepsis; 3 of 9 patients undergoing PSARP required reoperation due to complications.
Conclusions:
- Vaginostomy with or without cystostomy is recommended for patients with anatomical malformations, hydrocolpos, and bladder enlargement to mitigate complications.
- Long-term follow-up is essential to monitor the effects of vaginal drainage on bladder dilation and to assess the ultimate results of corrective surgery.
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.
