Abstract
Purpose
Experience with male cloaca (MC), a single opening in perineum for passage of urine and meconeum is described.
Methods
Cases of MC were ambispectively studied, prospectively from July 2007 to April 2015 and retrospectively for last three decades.
Results
Seven cases of MC were identified, between the ages of newborn—4 years (median 10 days). Two missed cases underwent a colostomy, posterior sagittal anorectoplasty, and urethroplasty. Two cases underwent perineal urethrostomy and anoplasty followed by urethroplasty. In one case, part of the rectal wall was used to form urethral tube and urethrostomy. For three recent cases, posterior sagittal anorectourethroplasty was done with mobilization of rectal pouch and common channel, separation of common wall between the urethra and rectum, urethroplasty varying from 1.5 to 3 cm, perineal body reconstruction, perineal urethrostomy and anoplasty. Follow-up of 6 patients varied from 3 months to 23 years. One case is lost to follow-up. Three patients have completed repair. Complications included a discharging sinus and a urethral fistula in one case each. One patient died while awaiting urethroplasty. Two patients are awaiting formal urethroplasty.
Conclusion
With familiarity of varying anatomy of MC, early recognition can avoid a neonatal colostomy in selected patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Livingston JC, Elicevik M, Breech L, Crombleholme TM, Peña A, Levitt MA (2012) Persistent cloaca: a 10-year review of prenatal diagnosis. J Ultrasound Med 31:403–407
Bischoff A, Levitt MA, Lim FY, Guimarães C, Peña A (2010) Prenatal diagnosis of cloacal malformations. Pediatr Surg Int 26:1071–1075
Peña A, Kessler O (1998) Posterior cloaca: a unique defect. J Pediatr Surg 33:407–412
Major SG (1929) Persistence of the cloaca: report of a case. Minn Med 12:96–97
Qureshi F, Jacques SM, Yaron Y, Kramer RL, Evans MI, Johnson MP (1998) Prenatal diagnosis of cloacal dysgenesis sequence: differential diagnosis from other forms of fetal obstructive uropathy. Fetal Diagn Ther 13:69–74
Wheeler PG, Weaver DD (2001) Partial urorectal septum malformation sequence: a report of 25 cases. Am J Med Genet 103:99–105
Qureshi F, Jacques SM (2012) Cloacal abnormalities in male fetuses. J Ultrasound Med. 2012(31):2046–2047 (author reply 2047–8)
Sharma S, Gupta DK (2012). Cloaca in a male; diagnosis on suspicion. Presented during the 19th Colorectal Club meeting. Rome, 11–12 June. 2012. http://www.colorectalclub2012.altervista.org/program.html
Banu T, Chowdhury TK, Hoque M, Rahman MA (2013) Cloacal malformation variants in male. Pediatr Surg Int 29:677–682
Sharma AK, Goel D, Kothari SK (1999) Perineal-mound defects. Pediatr Surg Int 15:227–229
Dravis C, Yokoyama N, Chumley MJ, Cowan CA, Silvany RE, Shay J, Baker LA, Henkemeyer M (2004) Bidirectional signaling mediated by ephrin-B2 and EphB2 controls urorectal development. Dev Biol 271:272–290
Yucel S, Dravis C, Garcia N, Henkemeyer M, Baker LA (2007) Hypospadias and anorectal malformations mediated by Eph/ephrin signaling. J Pediatr Urol 3:354–363
Dannull K, Sung J (2014) Cloacal dysgenesis diagnosis by prenatal ultrasound and MRI. Pediatr Radiol 44:230–233
Le Borgne H, Philippe HJ, Le Vaillant C (2011) Contribution of three-dimensional ultrasonography in depicting perineal features in cloacal malformation. Fetal Diagn Ther 30:239–240
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sharma , S., Gupta, D.K. Male cloaca malformation: rare variant of anorectal malformation. Pediatr Surg Int 31, 747–752 (2015). https://doi.org/10.1007/s00383-015-3738-4
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-015-3738-4