Reconstructive surgery for cloacal anomalies.

This paper describes a variety of surgical techniques which have been employed in three patients with cloacal anomalies, at the Kobe Children's Hospital during a period from 1977 to 1983. The patients presented with malformations in which the urethra, vagina and rectum converge at the high level of cloaca. Staged approach was mandatory in these patients. A loop colostomy with the distal loop of colon separated from the fecal stream and a decompressing vaginostomy are the initial procedures for this form of malformations. Vaginoplasty is required in some patients for pullthrough to the perineum. In those in whom the vagina and colon are separately pulled through, a posterior sagittal approach is convenient.