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Bladder
Congenital anomalies
Persistent cloaca
Author: Nat Pernick, M.D. (see Authors page)
Revised: 22 December 2009, UPDATE IN PROGRESS
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Defined as confluence of rectum, vagina and urethra into a single common chamber
Terminology
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● Also called cloacogenic bladder
Epidemiology
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● Occurs in 1 per 20,000 births, only in girls
Sites
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Etiology
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● 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
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● Dilated sac like structure in center of abdomen
● 80% have associated anogenital anomaly, including imperforate anus, absent genital or urinary orifices, renal agenesis, absence of prostate or seminal vesicles or poorly developed foregut derivatives
● May be identified prenatally by ultrasound or MRI in female fetus presenting with hydronephrosis and a large cystic lesion arising from the pelvis (Congenit Anom (Kyoto) 2009;49:116)
Prognostic factors
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Case reports
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● Prenatal diagnosis of persistent cloaca associated with VATER (Tohoku J Exp Med 2007;213:291)
Treatment
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● Reconstruction of cloaca by total urogenital mobilization (J Urol 2009;182:2455, eMedicine)
Clinical images
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Gross description (Macroscopy)
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Gross images
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Persistent cloaca serves as convergence of rectum and both ureters
Micro description (Histopathology)
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Micro images
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Cytology description
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Cytology images
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Positive stains
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Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● (link to topic)
Additional references
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End of Bladder > Congenital anomalies > Persistent cloaca
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