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Clinical Spectrum, Morphometrics, and Management of Perineal Cleft in Female Children

M A Baky Fahmy1, Ilhama Jafarli2, Ahmed Elkhouly3

  • 1Emeritus professor of pediatric surgery, Al-Azhar University, Egypt.

Journal of Pediatric and Adolescent Gynecology
|June 16, 2026
PubMed

Insights

Perineal cleft (PC) is a rare congenital anomaly in females. Most cases resolve spontaneously, but associated anorectal anomalies may require intervention, emphasizing the need for increased awareness.

Area of Science:

  • Pediatric Surgery
  • Congenital Anomalies
  • Female Genitourinary System

Background:

  • Perineal cleft (PC), or perineal groove, is a rare congenital anomaly of the female perineum.
  • It presents as a midline mucosal defect, often underrecognized and potentially linked to other anogenital malformations.

Purpose of the Study:

  • To investigate the prevalence, clinical spectrum, and associated anomalies of PC in female pediatric patients.
  • To analyze morphometric characteristics and evaluate management outcomes for PC.

Main Methods:

  • A prospective cross-sectional study of 4,100 female patients aged 1 day to 12 years.
  • Detailed clinical assessment, anogenital distance (AGD) measurement, and histopathological evaluation were performed.
  • Examination under general anesthesia was conducted in selected cases.

Main Results:

  • PC was diagnosed in approximately 1.27% of patients (52 cases).
  • Associated findings included hymenal lesions and anorectal anomalies; AGD was significantly shorter in affected patients.
  • Most isolated defects resolved spontaneously; 15 patients required surgery, mainly for anorectal malformations.

Conclusions:

  • Perineal cleft is an uncommon congenital anomaly often associated with hymenal and anorectal issues.
  • The majority of cases are asymptomatic and resolve spontaneously, supporting conservative management.
  • Increased awareness is crucial to prevent misdiagnosis and unnecessary procedures.
Abstract

Keywords:
Perineal cleftanogenital distanceanorectal malformationcongenital perineal anomalyhymenal tagperineal groove

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