Surgical reconstruction of a high cloacal anomaly with two short vaginas.

We treated a patient with a complex cloacal malformation: a high confluence cloaca and 2 separate short vaginas. At the age of 1 year and 2 months the rectocloacal fistula was closed because of frequent urinary infections, and the vaginas were separated from the wide urogenital sinus and anastomosed to the lower colon. At the age of 2 years and 4 months the lower colon, which had been anastomosed with the 2 vaginas, was pulled down to the perineum to serve as a lower vagina, and the sigmoid colon was pulled through to form a neorectum. She is now 7 years old and goes to school without problems of bowel function or urinary function except that catheterization is done twice a day.