EXPERIENCES
OF TOTAL UROGENITAL MOBILIZATION IN LOW CLOACA (REPORT OF 2 CASES)
Ma JD, Ye ZZ, Zhang XL,
Zhao YM, Ma RB
Department of Surgery,
Capital Institute of Pediatrics, China 100020
Objective: To evaluate
the total urogenital mobilization in the treatment of low cloaca in 2
cases.
Methods: Case 14y10m
girl has abnormal since birth and under went colostomy and “anoplasty” in
another hospital. Cystostomy a big fecalith extraction and 6 months later a
posterio-sagittal total urogenital mobilization were carried out. Finally
the urethra vagina (wall of cloaca in fact) and rectum were fixed to the
perineum.
Case2, 6y. Her abnormal perineum was found at 6 months of age.
After a failed “perineal anoplasty” she could pass urine and feces only
through a 1cm opening for years. Two weeks after colostomy of transverse
colon duplicated vagina and uterus. Right hydronephrosis and
hydroureterosis was
diagnosed during the total urogenital mobilization. A similar procedure was
finished as in case 1.
Results: The
appearance of perineum is satisfied with continence of urine and feces.
Conclusions: total
urogenital mobilization is indicated for low cloacas. Its advantages are:
more simple method, wide visual field, short operating time, without
opening the abdomen, less stress, satisfied appearance of perineum,
acceptable continence of urine and feces, and more physiologic. Early and
correct diagnosis is very important. The final results are also dependent
on the technique and experience of the surgeons.