3-Year-Old Female Patient with Total Urinary Incontinence and Unusual Cloacal Variant (Hendren Patient Case)

Case Overview: 
  • 3-year-old female patient referred for total urinary incontinence in March 1980, with an unusual cloacal variant
  • At birth, exploration showed a short colon attached to the dome of a small bladder by its cecum with two appendices, the usual situation in cloacal exstrophy
  • That was divided and exteriorized
  • An ileostomy was also performed
Follow Up: 
  • Family moved several time between two mid-western states (USA) and were not communicative with any of the three surgeons involved with her care

In April 1991, at age 14 years

  • Original surgeon longitudinally slit her colonic pouch behind her bladder to make a vagina from its front half and a rectum from its back half  

In March 1993, at age 16 years

  • Patient was completely dry after a bladder sling of rectus fascia and intermittent catheterization

Additional Updates

  • Normal menses from two small uteri presumably implanted into colon vagina in 1991
  • Coitus was not possible because of vaginal stenosis
  • Bowel control: patient wore pads to prevent soiling (Electrical stimulation in infancy had indicated scant contraction.)
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