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Updated: Aug 11, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Surgical reconstruction of a high cloacal anomaly with two short vaginas
1Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Japan.
Insights
This study details a surgical approach for complex cloacal malformation in a young patient, involving rectocloacal fistula closure and vaginal separation. The patient achieved improved bowel and urinary function with daily catheterization.
Area of Science:
- Pediatric Surgery
- Urology
- Gastroenterology
Background:
- Complex cloacal malformation presents significant surgical challenges.
- Early intervention is crucial for managing associated urinary infections and anatomical abnormalities.
Observation:
- A patient with a high confluence cloaca and two separate vaginas underwent staged surgical reconstruction.
- Initial surgery involved rectocloacal fistula closure and separation/anastomosis of vaginas to the lower colon.
Findings:
- A subsequent procedure utilized the lower colon as a neovagina and the sigmoid colon as a neorectum.
- At age 7, the patient demonstrates successful bowel and urinary function, requiring only twice-daily catheterization.
Implications:
- This reconstructive technique offers a viable solution for complex cloacal malformations.
- Successful surgical management can lead to improved quality of life and functional outcomes in affected children.
Abstract:
We treated a patient with a complex cloacal malformation: a high confluence cloaca and 2 separate short vaginas. At the age of 1 year and 2 months the rectocloacal fistula was closed because of frequent urinary infections, and the vaginas were separated from the wide urogenital sinus and anastomosed to the lower colon. At the age of 2 years and 4 months the lower colon, which had been anastomosed with the 2 vaginas, was pulled down to the perineum to serve as a lower vagina, and the sigmoid colon was pulled through to form a neorectum. She is now 7 years old and goes to school without problems of bowel function or urinary function except that catheterization is done twice a day.
