Posterior sagittal anorecto-urethro-vaginoplasty

Abstract

A cloaca is a congenital malformation that occurs in females, in which the rectum and urogenital tract develop as a single perineal orifice. The vagina, urethra, and rectum are fused together inside the pelvis, creating a single common channel that emerges where the urethra normally opens. Incidence of cloacal anomalies is about 1 in every 20,000 live births. There are two major groups of patients with cloaca: One that comprises patients who are born with a common channel shorter than 3 cm and another that comprises patients with a longer common channel. For surgical correction, these two groups require technically different procedures. Patients with a common channel shorter than 3 cm require posterior sagittal anorecto-urethro-vaginoplasty or total urogenital mobilization, whereas patients with a common channel that is longer than 3 cm require vaginoplasty using a segment of bowel.