Yan Jiayu,Chen Yajun,Peng Chunhui,et al.Clinical diagnosis and treatment of cloacal malformation in boys[J].Journal of Clinical Pediatric Surgery,,19():878-883.[doi:10.3969/j.issn.1671-6353.2020.10.004]
Clinical diagnosis and treatment of cloacal malformation in boys
- Keywords:
- Digestive System Abnormalisties; Cloaca/AB; Male; Diagnosis; Therapy
- CLC:
- R726.1;R726.2;R657.1
- Abstract:
- Objective To explore the clinical characteristics,diagnosis,surgery and prognosis of cloacal malformation (CM) in boys.Methods A retrospective analysis was conducted for 4 CM boys aged over 4 years from January 2005 and December 2019.Their defecation and urination functions were evaluated by Rintala score and dysfunctional voiding scoring system (DVSS) respectively.Based upon total Rintala score (0-20),three categories of defecation function were assigned:≥17 normal defecation function,12-16 mild defecation dysfunction and<12 severe defecation dysfunction;the higher total DVSS score (0-30),the worse urination function.Results All of them had one single perineal opening for passing stool and urine without normal anus after birth.The age of admission of three boys on full-course treatment was 5,5,12 and 2 months respectively.Another 129-month-old boy with rectourethral fistula after undergoing urethroplasty at another hospital was admitted.All were associated with severe hypospadias and penoscrotal transposition.Perineal examination plus auxiliary examinations could effectively diagnose the disease and associated malformations.Anorectal,urological and other associated anomalies were resolved successively and one boy had postoperative rectal perineal fistula.Posterior sagittal anorectoplasty and rectourethral fistula repair was performed for rectourethral fistula.Three boys were followed up until an age of 6,11 (with sacral abnormality) and 15 (with sacral abnormality).They had Rintala score of 20,12,10 and DVSS of 0,10,3 respectively.Conclusion Physical and auxiliary perineal examinations are crucial for diagnosing CM and associated malformations in boys.Perineal anoplasty and urethroplasty may be performed for CM boys.Defecation and urination functions are closely related with sacral abnormalities.
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Memo
收稿日期:2020-02-03。
基金项目:中国工程院-外科扶持基金
通讯作者:陈亚军,Email:chenyajunmd@aliyun.com