Surgical treatment of cloacal anomalies.
From 1989-1998 14 patients were treated with cloacal anomalies: 5 typical cloacas (PC), 5 posterior cloacas, and 4 cloacal exstrophies (CE); 12 underwent surgery. Four typical cloacas were resolved with posterior sagittal anorectovagino-urethroplasty (PSARVUP), whereas in the 5th total urogenital mobilization (TUM) was used. Three PCs were managed with transanorectal TUM and 2 with anterior TUM without opening the anal canal and rectum (without a protective colostomy). Two CEs were treated with atypical procedures. Two patients with CE died without surgery and 2 died after surgery due to complex associated anomalies. During postoperative follow-up of 1-8 years, 5 children had voluntary bowel movements and no soiling while the others had soiling with or without enemas; 1 had stress incontinence; 3 were on clean intermittent catheterization due to neurogenic bladder and were dry. PSARVUP provides a satisfactory result if there is no sacral anomaly. TUM makes this operation easier to perform. In patients with a PC it is sometimes possible using TUM to separate the urinary from the genital tract and remove the accessory urethra without opening the anus and rectum.
Krstic
Z D
ZD
Department of Pediatric Surgery, University Children's Hospital, Tirsova 10, 11000 Belgrade, Serbia, Yugoslavia.
Lukac
M
M
Lukac
R
R
Smoljanic
Z
Z
Vukadinovic
V
V
Varinac
D
D
D002675:Child, Preschool; D002988:Cloaca / Q000002:abnormalities* / Q000601:surgery*; D003125:Colostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D012007:Rectum / Q000002:abnormalities / Q000601:surgery; D016896:Treatment Outcome; D014521:Urethra / Q000002:abnormalities / Q000601:surgery; D014564:Urogenital Abnormalities / Q000401:mortality / Q000601:surgery*; D013519:Urogenital Surgical Procedures; D014621:Vagina / Q000002:abnormalities / Q000601:surgery