Cloacal Endoscopy

Persistent cloaca is one of the most complex anorectal anomalies.

In persistent cloaca, the length of the common channel is directly related to the complexity of the reconstruction.

Cloacal endoscopy is a very important component of the workup of persistent cloaca patients.

Cloacal endoscopy is performed using a pediatric cystoscope.

In a short common channel, all three orifices (urethra, vagina, and rectum) are identified within a short distance of the perineum.

A longitudinal septum resulting in two hemivaginas is commonly seen in persistent cloaca.

In the demonstrated short common channel case, the common channel measured approximately 2.5 centimeters.

In the demonstrated long common channel case, the first bifurcation is seen approximately 3 centimeters from the perineum.

In the demonstrated long common channel case, a trifurcation is seen another 3 centimeters more proximal to the first bifurcation.

In the demonstrated long common channel case, the trifurcation is formed by two hemivaginas anteriorly and the rectum posteriorly.

Each hemivagina terminates in a cervical os.

The rectal opening into the cloaca is seen posterior to the reproductive tract.

In the demonstrated long common channel case, the common channel measured approximately 6 centimeters.