Case Overview:
- 3-year-old female patient referred for total urinary incontinence in March 1980, with an unusual cloacal variant
- At birth, exploration showed a short colon attached to the dome of a small bladder by its cecum with two appendices, the usual situation in cloacal exstrophy
- That was divided and exteriorized
- An ileostomy was also performed
Follow Up:
- Family moved several time between two mid-western states (USA) and were not communicative with any of the three surgeons involved with her care
In April 1991, at age 14 years
- Original surgeon longitudinally slit her colonic pouch behind her bladder to make a vagina from its front half and a rectum from its back half
In March 1993, at age 16 years
- Patient was completely dry after a bladder sling of rectus fascia and intermittent catheterization
Additional Updates
- Normal menses from two small uteri presumably implanted into colon vagina in 1991
- Coitus was not possible because of vaginal stenosis
- Bowel control: patient wore pads to prevent soiling (Electrical stimulation in infancy had indicated scant contraction.)
THP Source: