Abdominoperineal anoplasty with use of a rectal fistula as a substitute vagina in a cloacal malformation associated with absence of the vagina: short-term follow-up

We report herein a patient with a cloacal malformation and an absent vagina. The patient underwent colostomy on Day 1 of life. At 7 months of age, fistulography of the cloaca showed a common channel >3 cm in length; a vagina was not visible. At the age of 11 months, the patient underwent abdominoperineal anoplasty with the repurposing of her rectal fistula as a substitute vagina. Intraoperative examination revealed a bicornuate uterus and bilateral ovaries. The rectum was resected 7 cm at the confluence of the cloaca. The colonic stump was pulled through a newly created anal canal and an anoplasty was performed. Two months after this procedure, the patient experienced anal prolapse. At the age of 17 months, she underwent partial urogenital mobilization and a modified Delorme operation, and 5 months later the colostomy was closed. At present, this patient is 3 years old and doing well.