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A unique defect – persistent posterior cloaca: An example of staged genito‐urinary and digestive tract reconstruction with an alternative vaginal creation using the urinary bladder wall
Author(s) -
Komasara Leszek,
BryksLaszkowska Anna,
Sroka Mariusz,
Gołębiewski Andrzej,
Czauderna Piotr
Publication year - 2017
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13332
Subject(s) - medicine , cloaca , vagina , vaginoplasty , vulva , colostomy , anatomy , uterus , surgery , anastomosis , stoma (medicine) , urinary diversion , urinary system , pubic symphysis , agenesis , urinary bladder , cystectomy , pelvis , bladder cancer , cancer
We present a case of a girl with an extremely rare, posterior type of persistent cloaca, which was associated with other abnormalities, including an undeveloped vulva and vagina, agenesis of the right kidney, secondary obstructive megaureter, unicornate uterus, persisted tailgut, sacral bone hypoplasia, and pubic symphysis hypertrophy. An operative approach was as follows: (i) colostomy and ureterocutaneostomy; (ii) creation of an ileal conduit with antirefluxing uretero‐ileal anastomosis, and then creation of a continent catheterizable ileal reservoir; (iii) anastomosis of sigmoid colon to rectal stump; and (iv) vaginal and external genital reconstruction. Because of abnormal anatomical conditions where the uterus was situated adjacent to the open, incompetent bladder neck, we decided to create a vagina using the bladder wall instead of the bowel segment.