Endoscopic surgery as an adjuvant treatment modality before or after definitive correction of cloacal anomalies.

OBJECTIVE: To evaluate the effectiveness of endoscopic surgery before or after definitive correction in patients with a persistent cloaca.

MATERIALS AND METHODS: The medical records of 16 patients diagnosed with persistent urogenital sinus at our institution were retrospectively reviewed. Of these 16 patients, five underwent endoscopic surgery, such as visual internal urethrotomy or transurethral incision by a single surgeon at the time of or after colostomy formation or corrective surgery.

RESULTS: All patients underwent colostomy 1-2 days after birth. Three patients were treated by endoscopic procedures before corrective surgery owing to voiding difficulty, urinary tract infection, or hydrocolpos, at a median age of 1 month. Another two patients underwent endoscopic surgery after definitive correction of the cloaca owing to urethral stricture or urinary incontinence. After endoscopic surgery, all patients voided well without residual urine or were catheterised easily without incontinence. Endoscopic modality played a substantial role in managing complications or resolving the anatomical barrier to decompress the genitourinary tract in patients with a common urogenital sinus length of <3 cm.

CONCLUSIONS: Endoscopic surgery for a cloacal anomaly is a minimally invasive adjuvant technique for bladder neck obstruction, urethral stricture, and hydrocolpos with a thickened vaginal septum.