Male cloaca malformation: rare variant of anorectal malformation

Area of Science:

• Pediatric Surgery
• Urology
• Congenital Anomalies

Background:

• Male cloaca (MC) is a rare congenital anomaly characterized by a single perineal opening for urinary and fecal streams.
• Understanding the variable anatomy of MC is crucial for appropriate management.

Purpose of the Study:

• To describe the experience with male cloaca (MC).
• To evaluate surgical management strategies and outcomes for MC.

Main Methods:

• An ambispective study of MC cases was conducted, combining prospective data (July 2007-April 2015) and retrospective data from the preceding three decades.
• Surgical interventions included posterior sagittal anorectoplasty, urethroplasty, perineal urethrostomy, and anoplasty, with detailed descriptions of techniques used.

Main Results:

• Seven cases of MC were identified in patients aged newborn to 4 years (median 10 days).
• Surgical approaches varied, with posterior sagittal anorectourethroplasty performed in recent cases.
• Complications included a discharging sinus and urethral fistula; one patient died awaiting surgery, and two are awaiting repair.

Conclusions:

• Familiarity with the diverse anatomy of male cloaca is essential for effective surgical planning.
• Early recognition and timely surgical intervention can potentially prevent the need for neonatal colostomy in selected MC patients.