15-year-old female patient referred in 1981 for cloacal repair Work up at birth at two University Centers concluded patient had female pseudohermaphroditism without endocrine cause Prior surgery was cutback of UGS and laparotomy to view (normal) pelvic organs.
14-month-old female patient referred in 1993 for cloacal reconstruction Duodenal atresia had been repaired at birth, and right transverse colostomy There was massive reflux bilaterally Bilateral reimplants had been done at age 3 months, but massive reflux persisted
Newborn female patient Esophageal atresia repaired as neonate Had cloaca Loop sigmoid colostomy was done Referred at age 5½ years for cloacal repair Chronic spillover of stool from loop colostomy, filling vagina and bladder with reflux, severe renal scaring
18-month-old female patient referred with total urinary incontinence Prior colostomy at birth Soave type rectal pullthrough at 1 year, and later colostomy closure.
4-year-old female patient with total urinary incontinence Cloaca with features seen in clocal exstrophy Ileocolic junction originally joined bladder Distal colon originally joined bladder Distal colon originally ended blindly Two adjoining bladders After an endoscopy 2 weeks later there was reasonable outlet resistance
4-year-old girl sent from abroad in 1986 Right colostomy at birth At age 4 months, posterior sagittal operation was attempted, but abandoned after the UGS was inadvertently transected An S.P. tube was placed 8 months later, colostomy was closed and a stricture of the neourethra was opened endoscopically Patient was sullen, unhappy, and uncommunicative when first seen
15-month-old baby girl with a cloaca and a very large intrapelvic sacrococcygeal teratoma Prior suprapubic cystostomy and sigmoid colostomy at birth
20-year-old female totally incontinent of urine and stool when referred in 1979 Prior operations included colostomy, colon pullthrough, right nephrectomy, and a flap to enlarge the UGS opening She was in diapers
Neonate in 1964 with very primitive anatomy with features usual in babies with cloacal exstrophy
Neonate treated in 1975-- ear ly in experience with cloacal reconstruction Sigmoid colostomy was done, but transverse colostomy now preferredDemonstrated repair in lithotomy position to be possible, although today a posterior sagittal approach might be used Hendren's first cloacal repair in 1962 had the vagina exteriorized with a perineal flap, and the rectum was repaired by a posterior sagittal approach and pullthrough
