Total urogenital mobilization by posterior sagittal approach and ileal neovaginoplasty in cloacal repair by a common channel of 4 cm

Abstract

Objective: The total urogenital mobilization (TUM) technique avoids dissection of the vagina from the urinary tract. However, in the case of a long common channel, bowel interposition for vaginal replacement may be necessary. We present a video of the TUM technique in cloacal repair with ileal neovaginoplasty.

Methods: An 8-month-old female patient with cloaca, presenting a 4-cm common channel, was operated on by the TUM technique, through a perineal sagittal with additional abdominal approach. She had undergone decompressing colostomy at birth. Total urogenital sinus mobilization was performed with ileal neovaginoplasty.

Results: The patient had a good postoperative outcome, an endoscopy of all structures reconstructed was performed at PO day 30, and home dilatation of colon and vagina by parents was initiated.

Conclusion: TUM with neovaginoplasty bowel interposition is an effective technique for repairing long common channels.

Keywords: Cloaca; Cloacal anomalies; Urogenital abnormalities; Urogenital surgical procedures; Vaginal reconstruction.