Abstract
Purpose: The long-term outcome of urogenital functions with cloacal anomalies has been challenging, particularly in a high-confluence group. We developed a partial urogenital mobilization (PUM) procedure with modification from the total urogenital mobilization (TUM) method. We evaluated the short-term complications and long-term urogenital functions from our cumulative data.
Methods: We reviewed patients with cloacal anomaly in a high-confluence group. We defined patients with an anatomical confluence-point located above the PC line as the high-confluence group. We evaluated the complications and functional outcomes after operation, and performed a historical comparison between the procedures.
Results: Seven cases were categorized as belonging to the high-confluence group. The age of the patients ranged from 2 to 31 years. Four patients, who had undergone operations that included separation of vagina from the urinary tract, indicated short-term complications of urethral injury, vaginourethral fistula and vaginal stenosis. Long-term clean intermittent catheterization (CIC) was required for all cases. As we explored for an alternative procedure, we developed PUM and performed in 3 patients. Although long-term outcomes of PUM are still under evaluation, the short-term outcomes have been favorbale, since the patients were free of the post-surgical complications and had better bladder function.
Conclusion: Patients with cloacal anomaly in the highconfluence group may have benefited from the PUM procedure with less short-term complications and better bladder function. Evaluations of the long-term outcomes of urogenital functions are under progress, and will be reported on completion in future.
