Clinical Characteristics of Children with Persistent Cloaca: A Urological Perspective

Bang, Woo Jin; Lee, Hye Young; Han, Sang Won

doi:10.4111/kju.2008.49.1.77

Korean J Urol. 2008 Jan;49(1):77-81. Korean.
Published online Jan 31, 2008.
https://doi.org/10.4111/kju.2008.49.1.77

Original Article

Clinical Characteristics of Children with Persistent Cloaca: A Urological Perspective

Woo Jin Bang, Hye Young Lee and Sang Won Han

Author information

Author notes

Copyright and License

- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Email: swhan@yuhs.ac

Received September 18, 2007; Accepted October 29, 2007.

Abstract

Purpose

Persistent cloaca is a rare multiple anomalous condition which involves the gastrointestinal, neurological and urogenital systems. We evaluated the clinical characteristics and urogenital anomalies of patients with persistent cloaca, and we investigated the factors that must be considered from a urological perspective.

Materials and Methods

We retrospectively reviewed the medical records of 11 patients who were diagnosed with persistent cloaca at our institution during the last 7 years.

Results

Nine of the 11 patients who were followed up at the urology clinic were subjected to this study. Nonspecific abnormalities, such as antenatal hydronephrosis, were noted in 5 of 9 patients. The chief complaints upon visits to the urologic clinic were recurrent urinary tract infections in 3, preoperative evaluation before neurosurgery in 3, urinary incontinence in 1, urinary retention in 1 and an elevated creatinine level in 1. The urological anomalies included 2 cases of renal agenesis and 1 horseshoe kidney. Vesicoureteral reflux was noted in 6 patients, and 4 of these patients underwent antireflux surgery. Videourodynamic study was performed in 8 patients and all of them were diagnosed with neurogenic bladder. Currently, 5 children are on intermittent catheterization, 2 have undergone vesicostomy and 2 void spontaneously.

Conclusions

Most patients with persistent cloaca had urological anomalies of the upper urinary tract and neurogenic bladder. Therefore, a multidisciplinary approach for diagnosis and treatment from various departments, including the urology, pediatric surgery, neurosurgery departments is mandatory.

Keywords

Cloaca; Urogenital abnormalities

Tables

Table 1
The patients' profile and associated anomalies

Click for larger image

Table 2
Urological problems and managements

Click for larger image

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