Endoscopic surgery as an adjuvant treatment modality before or after definitive correction of cloacal anomalies.
OBJECTIVE
To evaluate the effectiveness of endoscopic surgery before or after definitive correction in patients with a persistent cloaca.


METHODS
The medical records of 16 patients diagnosed with persistent urogenital sinus at our institution were retrospectively reviewed. Of these 16 patients, five underwent endoscopic surgery, such as visual internal urethrotomy or transurethral incision by a single surgeon at the time of or after colostomy formation or corrective surgery.


RESULTS
All patients underwent colostomy 1-2 days after birth. Three patients were treated by endoscopic procedures before corrective surgery owing to voiding difficulty, urinary tract infection, or hydrocolpos, at a median age of 1 month. Another two patients underwent endoscopic surgery after definitive correction of the cloaca owing to urethral stricture or urinary incontinence. After endoscopic surgery, all patients voided well without residual urine or were catheterised easily without incontinence. Endoscopic modality played a substantial role in managing complications or resolving the anatomical barrier to decompress the genitourinary tract in patients with a common urogenital sinus length of <3 cm.


CONCLUSIONS
Endoscopic surgery for a cloacal anomaly is a minimally invasive adjuvant technique for bladder neck obstruction, urethral stricture, and hydrocolpos with a thickened vaginal septum.
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Centre, Pungnap-Dong 388-1, Songpa-Gu, Seoul, Republic of Korea. Electronic address: mdexodus@amc.seoul.kr.
Sang Hoon
SH
Song
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Centre, Pungnap-Dong 388-1, Songpa-Gu, Seoul, Republic of Korea. Electronic address: sunan99@naver.com.
Aram
A
Kim
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Centre, Pungnap-Dong 388-1, Songpa-Gu, Seoul, Republic of Korea. Electronic address: lbj1986@daum.net.
Bumjin
B
Lim
Department of Urology, Ulsan University Hospital, Ulsan, Republic of Korea. Electronic address: scpark@amc.seoul.kr.
Sungchan
S
Park
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Centre, Pungnap-Dong 388-1, Songpa-Gu, Seoul, Republic of Korea. Electronic address: kskim2@amc.seoul.kr.
Kun Suk
KS
Kim
D015331:Cohort Studies; D003106:Colon / Q000002:abnormalities* / Q000601:surgery; D003125:Colostomy / Q000379:methods; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014521:Urethra / Q000002:abnormalities / Q000601:surgery; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*
Cloaca; Endoscopy; Urethra