Persistent cloaca
Medical condition
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Key Takeaways
- A persistent cloaca is a symptom of a complex anorectal congenital disorder, in which the rectum, vagina, and urinary tract meet and fuse, creating a cloaca, a single common channel.
- The severity of the condition depends on where the three tracts have joined together.
- The length of the common channel can be used to judge prognostic outcomes and technical challenges during surgical repair.
- This type of malformation happens when the embryonic anorectal and urogenital channels fail to separate during the sixth and seventh weeks of gestational development.
- Diagnosis Diagnosis of a female with a cloaca should be suspected in a female born with an imperforate anus and small looking genitalia.
A persistent cloaca is a symptom of a complex anorectal congenital disorder, in which the rectum, vagina, and urinary tract meet and fuse, creating a cloaca, a single common channel.
Signs and symptoms
Cloacas appear in a wide spectrum of variation in females born with the malformation. The severity of the condition depends on where the three tracts have joined together. The single orifice, called a common channel, may occur varying in length from 1 to 10 cm. The length of the common channel can be used to judge prognostic outcomes and technical challenges during surgical repair. A common channel less than 3 cm in length usually has good sphincter muscles and a well-developed sacrum. This type of malformation happens when the embryonic anorectal and urogenital channels fail to separate during the sixth and seventh weeks of gestational development. Cloacal malformations are rare; they only occur in approximately 1 in 50,000 live births.
Diagnosis
Diagnosis of a female with a cloaca should be suspected in a female born with an imperforate anus and small looking genitalia. The diagnosis can be made clinically with tests like ultrasound, X-rays, voiding cystourethrogram (VCUG) and cloacagram. MRI of the spine and pelvis and endoscopic examinations may also be performed. Failure to identify a cloaca as being present in a newborn may be dangerous, as more than 90% have associated urological problems. The goal for treatment of a female born with cloaca is to achieve bowel control, urinary control, and sexual function, which includes menstruation, sexual intercourse, and possibly pregnancy. Cloacas probably occur in 1 in 20,000 live births.
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