Abstract
An extremely rare case of rectocloacal type of anorectal malformation was presented. The urinary bladder and urogenital sinus have formed a huge cloacal cavity and the border between these two structures was not able to identify. A very hypoplastic double vagina opened into this huge cloacal cavity. The right ureter which entered the vesical diverticulum was hydroureteric due to the stricture at the uretero-diverticular junction. The left double pyeloureteric system demonstrated vesicoureteric reflux. The rectocloacal fistula joined to the distal narrow portion of the cloacal sinus. As for treatment, firstly, sacroabdominoperineal rectal pull through was carried out and secondarily the bilateral reimplantation of ureter (Politano-Leadbetter procedure) with excision of bladder diverticula and tapering of right megaureter were done. Now patient is doing quite well on both, micturition and defecation two years after surgery. The recontrutive surgery of the vagina is the future problem.
