Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 16;39(1):247.
doi: 10.1007/s00383-023-05539-2.

Long-term urological outcome of cloaca patients with multidisciplinary management

C Pellegrino  1 , M Agamennone  1   2 , B D Iacobelli  3 , B Turchi  1   4 , M L Capitanucci  1 , F Beati  5 , V Forlini  1   2 , M L Sollini  1   6 , C E Marras  7 , G Esposito  7 , P Palma  7 , G Della Bella  8 , R D'Urzo  8 , T Caldaro  9 , E Castelli  10 , A Conforti  5 , P Bagolan  11 , G Mosiello  1
Affiliations

Long-term urological outcome of cloaca patients with multidisciplinary management

C Pellegrino et al. Pediatr Surg Int. .

Abstract

Purpose: Urological management of Cloacal Malformation (CM) focuses on preserving renal function and continence. Study aim was to analyze urinary and intestinal outcomes in CM patients, considering the length of common channel (CC) and presence of occult spinal dysraphism (OSD).

Methods: Retrospective review of CM treated at our institution by a multidisciplinary team from 1999 to 2020. Patients with follow-up < 2.5 years were excluded. Length of CC, renal function, urinary and bowel outcomes, presence of associated anomalies (especially OSD) were evaluated.

Results: Twenty patients were included, median age at follow-up: 8 years (4-15). A long CC > 3 cm was described in 11 (55%). Chronic kidney disease was found in 3 patients. Urinary continence was achieved in 8/20 patients, dryness (with intermittent catheterization) in 9/20. Fecal continence was obtained in 3/20, cleanliness in 14 (under bowel regimen). OSD was present in 10 patients (higher prevalence in long-CC, 73%). Among OSD, 1 patient reached fecal continence, 7 were clean; 2 achieved urinary continence, while 6 were dry.

Conclusions: Length of CC and OSD may affect urinary and fecal continence. An early counseling can improve outcome at long-term follow-up. Multidisciplinary management with patient centralization in high grade institutions is recommended to achieve better results.

Keywords: Anorectal malformation; Bowel continence; Cloaca; Neurogenic bladder; Occult spinal dysrafism; Urinary continence.

PubMed Disclaimer

References

    1. Peña A, Levitt MA, Hong A et al (2004) Surgical management of cloacal malformations: a review of 339 patients. J Pediatr Surg 39(3):470–479. https://doi.org/10.1016/j.jpedsurg.2003.11.033 - DOI - PubMed
    1. Ruiz J, Tessi C, Szklarz T, Vazquez M, Siffredi J, Imizcoz FL, Gomez Y, Weller S, Burek C, Sager C, Bailez MM, Corbetta JP (2021) Long-term urological assessment and management of cloaca patients: a single tertiary institution experience. J Pediatr Surg 56(5):984–987. https://doi.org/10.1016/j.jpedsurg.2020.07.012 - DOI - PubMed
    1. Halleran DR, Wood RJ (2023) Cloacal malformations. StatPearls Publishing, Treasure Island
    1. Mosiello G, Capitanucci ML, Gatti C, Adorisio O, Lucchetti MC, Silveri M, Schingo PS, De Gennaro M (2003) How to investigate neurovesical dysfunction in children with anorectal malformations. J Urol 170(4):1610–1613. https://doi.org/10.1097/01.ju.0000083883.16836.91 - DOI - PubMed
    1. De Gennaro M, Rivosecchi M, Lucchetti MC, Silveri M, Fariello G, Schingo P (1994) The incidence of occult spinal dysraphism and the onset of neurovesical dysfunction in children with anorectal anomalies. Eur J Pediatr Surg 4(1):12–14. https://doi.org/10.1055/s-2008-1066144 - DOI - PubMed

LinkOut - more resources