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CC BY 4.0 · European J Pediatr Surg Rep. 2018; 06(01): e52-e55
DOI: 10.1055/s-0038-1660805
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Closure of a Recurrent Urethrovaginal Fistula in a Girl with Cloacal Anomaly Using Deflux Injection

Hanan Said
1   Department of Paediatric Surgery, International Medical Center, Jeddah, Jeddah, Saudi Arabia
,
Salahuddin S. Syed
2   Department of Paediatric Surgery, Children Hospital, Leeds, United Kingdom of Great Britain and Northern Ireland
,
Ali Zeinelabdeen
3   Department of Paediatric Surgery, King Fahd Armed Forces Hospital, Jeddah, Western, Saudi Arabia
,
Mohamed Negm Fayez
3   Department of Paediatric Surgery, King Fahd Armed Forces Hospital, Jeddah, Western, Saudi Arabia
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Publikationsverlauf

24. April 2017

25. April 2018

Publikationsdatum:
18. Juli 2018 (online)

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Abstract

In a girl born with cloaca, both hemivaginae and rectum were located above the bladder neck, and both ureters were connected to the hemivaginae. After diverting colostomy and cystovaginoscopy on the second day of life, the repair of cloaca was performed at 10 months of age by posterior sagittal anorecto vaginoplasty (PSARVP), including laparotomy and bilateral ureteric reimplantation. Eight months after the surgery, she developed a vesicovaginal fistula, which was repaired and closed by open surgery through the bladder. Three months after this procedure, a tiny urethrovaginal fistula was noticed, which was closed at the age of 2 years using hook diathermy to refresh the edges and was then closed by Deflux injection. The proper closure of the urethrovaginal fistula was confirmed by radiology and cystoscopy 3 months after the surgery. This report shows that injection of Deflux into a tiny urethrovaginal fistula following refreshing the edges may be a valid treatment option in selected cases.

Keywords

cloaca - urethrovaginal fistula - use of Deflux
 

  • References

  • 1 Stephens F, Smith ED. Classification, identification, and assessment of surgical treatment of anorectal anomalies. Pediatr Surg Int 1986; 1 (04) 200-205
    PubMedGoogle Scholar
  • 2 Hohlschneider AM, Hustson JM. Incidence and frequency of different types, and classification of anorectal malformations. Anorectal Malformations in Children: Embryology, Diagnosis, Surgical Treatment, Follow-up, 2006: 163-184
    Google Scholar
  • 3 Alexander F, Kay R. Technical considerations in the repair of cloacal vaginal deformities. J Urol 1995; 153 (3 Pt 1): 788-791
    CrossrefPubMedGoogle Scholar
  • 4 Bischoff A. The surgical treatment of cloaca. Semin Pediatr Surg 2016; 25 (02) 102-107
    CrossrefPubMedGoogle Scholar
  • 5 Levitt MA, Bischoff A, Peña A. Pitfalls and challenges of cloaca repair: how to reduce the need for reoperations. J Pediatr Surg 2011; 46 (06) 1250-1255
    CrossrefPubMedGoogle Scholar
  • 6 Peña A. Total urogenital mobilization–an easier way to repair cloacas. J Pediatr Surg 1997; 32 (02) 263-267 , discussion 267–268
    CrossrefPubMedGoogle Scholar
  • 7 Leclair M-D, Gundetti M, Kiely EM, Wilcox DT. The surgical outcome of total urogenital mobilization for cloacal repair. J Urol 2007; 177 (04) 1492-1495
    CrossrefPubMedGoogle Scholar