Management and long-term outcomes of cloacal anomalies: quality of life, intestinal and urinary function at a Latin American pediatric center.

PURPOSE: To present the management experience of patients with cloacal malformation treated between 2008 and 2023, evaluating intestinal and urinary function and long-term quality of life.

METHODS

Retrospective case series of surgically corrected cloaca patients between 2008 and 2023. Follow-up assessed intestinal and urinary outcomes and quality of life using the PEDsQL™ 4.0 scale.

RESULTS

Twenty-three patients were included: 52.2% with a long and 47.8% with a short common channel. In the short-channel group, 81.8% had associated malformations. Total urogenital mobilization via posterior sagittal approach was performed in 63.6%, with 54.5% postoperative complications. Constipation affected 70%, fecal continence reached 40%, and urinary continence 54.5%. Mean PEDsQL scores were 67.9/85.8 (parent/patient). In the long-channel group, 91.6% had associated anomalies. Urogenital mobilization with abdominal approach was required in 58.3%, and complications occurred in 66.6%. Constipation affected 50%, fecal continence was 50%, and urinary continence 27.2%. Mean PEDsQL scores were 68.9/68.7 (parent/patient).

CONCLUSION

Cloacal malformation is a rare, complex anomaly often associated with renal defects. Surgical management demands multidisciplinary care. Long-term outcomes show variable continence, but quality of life remains acceptable, particularly in less severe cases.