Bladder
Congenital anomalies
Persistent cloaca

Author: Alcides Chaux, M.D. (see Authors page)

Revised: 15 March2016, last major update April 2011

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Persistent cloaca
Cite this page: Persistent cloaca. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bladdercloacogenic.html. Accessed December 6th, 2016.
Definition / General
  • Defined as confluence of rectum, vagina and urethra into a single common chamber that opens into a single orifice where the normal urethral opening is located
  • Represents a wide spectrum of defects with the common denominator of a single perineal orifice
  • The length of the common chamber varies from 1-10 cm (average 3 cm)
Terminology
  • Also called cloacogenic bladder
Epidemiology
  • Occurs in 1 per 20,000 births, only in girls
Etiology
  • Cloaca is single canal from which the urinary, genital and intestinal tracts arise at gestational weeks 5-6
  • Persistent cloaca is due to failure of urogenital septum to divide rectum from urogenital sinus
  • May be related to B-class Eph/ephrin signaling (J Pediatr Urol 2007;3:354)
Clinical Features
  • Dilated sac like structure in center of abdomen
  • 80% have an associated anogenital anomaly, including imperforate anus, absent genital or urinary orifices, renal agenesis, absence of prostate or seminal vesicles or poorly developed foregut derivatives
  • 30% of patients present with hydrocolpos (dilated vagina filled with fluid, urine or mucus) and 40% have a duplicated Mullerian system
  • May be identified prenatally by ultrasound or MRI in a female fetus presenting with hydronephrosis and a large cystic lesion arising from the pelvis (Congenit Anom (Kyoto) 2009;49:116)
Case Reports
Treatment
Clinical Images

Images hosted on other servers:

Normal embryo at 25-27 days

Normal embryo at weeks 5-7

Diagram of persistent cloaca

Additional References