Abstract
Objective
The published surgical literatures have referred only to females as having cloacal defects and the incidence in males is not well established. As during embryogenesis, both sexes have to pass through the stage of a cloaca, there is every chance of development of cloacal anomalies in males also. Here, we are presenting our experience of male cloacal malformations.
Methods
We identified four cases of male cloaca by reviewing medical records of all anorectal malformation (ARM) patients treated at our institution in the past 19 years. Time of presentation, clinical, radiological, cystoscopic and operative findings, and outcomes were analysed.
Results
Out of 1,837 patients, we identified four cases (0.2 %) of male cloacal variants. All presented after 45 days (range 46 days to 28 years). Three of them had proximal hypospadias, two had a vaginal remnant and cystoscopic evaluation showed the length of the common channel ranged from 0.5 to 8 cm. One patient died of multiple anomalies and the other patients are doing well following reconstruction.
Conclusion
None of the male cloacal patients presented in the neonatal period, proximal hypospadias was the common external genital abnormality and half of them had a vagina. Surgical outcome was satisfactory. The scarcity of reported cases of this group is a subject of further research.
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Acknowledgments
We are very grateful to Prof J. M Hutson AO, Chair of Pediatric Surgery, Department of Pediatrics, University of Melbourne, Australia; Professor in Pediatric Surgery, Department of Urology, The Royal Children’s Hospital; honorary fellow, surgical research, Murdoch Children’s Research Institute for helping us with the manuscript.
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Banu, T., Chowdhury, T.K., Hoque, M. et al. Cloacal malformation variants in male. Pediatr Surg Int 29, 677–682 (2013). https://doi.org/10.1007/s00383-013-3322-8
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DOI: https://doi.org/10.1007/s00383-013-3322-8