Results of treatment of fifty children with persistent cloaca in one center

Abstract

BACKGROUND: The preserved cloaca is a particular type of anorectal anomaly. The combination of urological, genital, and rectal abnormalities makes radical reconstruction difficult.

MATERIALS AND METHODS: This study examined operations performed in 50 patients with persistent cloaca treated from 2010 to 2021. Two groups are presented: the first with 35 children and a short canal (<3 cm), and the second with 15 children and a long canal (>3 cm). We examined the prognosis for bowel control, the type of operation, the need for vaginal reconstruction, complications after surgery, and the days of hospital stay.

RESULTS: Anomalies of the Müllerian ducts in the second group (94%) were higher than in the first (36%) (p < 0.001). The sacral index and myelodysplasia did not differ in both groups. The sacral index in the first group was 0.62 ± 0.14, and in the second group, it was 0.58 ± 0.14 (p = 0.520). Myelodysplasia in the first group was 33%, and in the second group, it was 38% (p = 0.744). Total urogenital mobilization (51%) was used in the first group, and abdominal reconstruction (54%) was used in the second group. Vaginal reconstruction was required in 28% of patients in the first group and 60% in the second group. Complications were 3.5 times more likely in the first group (60% versus 17% in the second) (p = 0.003). The length of hospital stay in patients in the second group was longer than that of patients in the first group.

CONCLUSION: Our study data demonstrate that the reconstruction of a persistent cloaca requires individual planning of the operation, considering the length of the canal and the state of all structures forming the cloaca.

Keywords

persistent cloaca / anorectal malformations / hydrocolpos / laparoscopy / total urogenital mobilization / anorectoplasty / newborn

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RIGHTS & PERMISSIONS

Mokrushina O.G., Shumikhin V.S., Levitskaya M.V., Chundokova M.A., Halafov R.V., Shugina J.V., Petrova L.V., Koshko O.V., Emirbekova S.K.