I read with much interest the recent review by Vilanova-Sanchez et al regarding the
obstetrical outcomes of women with previous cloacal repairs.
1
I recently cared for a woman whose case adds nicely to this excellent review. The
patient, a 30-year-old physician, was born with a 2.5-cm cloaca with an associated
didelphys uterus and 2 hemivaginas. Definitive surgical repair was undertaken at 19 months
of age by Dr Alberto Pena, one of the surgical pioneers, who was visiting Sydney at
that time.
2
The patient underwent a posterior sagittal anorectoplasty including excision of the
vaginal septum. Subsequently, in childhood, a bilateral ureteric reimplantation was
performed for vesicoureteral reflux.To read this article in full you will need to make a payment
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References
- Obstetrical outcomes in adult patients born with complex anorectal malformations and cloacal anomalies: a literature review.J Pediatr Adolesc Gynecol. 2019; 32: 7
- Surgical management of cloacal malformations: a review of 339 patients.J Pediatr Surg. 2004; 39: 470
Article info
Publication history
Published online: February 04, 2019
Footnotes
The author indicates no conflicts of interest.
Identification
Copyright
© 2019 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Obstetrical Outcomes in Adult Patients Born with Complex Anorectal Malformations and Cloacal Anomalies: A Literature ReviewJournal of Pediatric and Adolescent GynecologyVol. 32Issue 1
- PreviewPatients born with complex anorectal malformations often have associated Müllerian anomalies, which might affect fertility and obstetrical outcomes. Other vertebral-anorectal-tracheoesophageal-renal-limb associations, such as renal or cardiac anomalies, could also affect pregnancy intention, fertility rates, and recommendations about mode of delivery or obstetrical outcomes. Associated conditions present at birth, like hydrocolpos, could also potentially affect fertility. Depending on the complexity of the anomaly, primary reconstruction might include vaginoplasty, vaginal interposition, perineal body reconstruction, and extensive pelvic dissection.
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