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CC BY 4.0 · European J Pediatr Surg Rep. 2022; 10(01): e93-e97
DOI: 10.1055/s-0042-1750409
Case Report

Cloaca-Like Anomalies in the Male: A Report on Two Cases

Amr AbdelHamid AbouZeid 
1   Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
,
Shaimaa Abdelsattar Mohammad
2   Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt
,
Marco Rady Sos
1   Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
,
Nader Nassef Guirguis
1   Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
,
Heba A. Mahmoud
3   Department of Pathology, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Manal El-Mahdy
3   Department of Pathology, Ain Shams University Faculty of Medicine, Cairo, Egypt
› Author Affiliations Funding None.
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Abstract

“Cloaca” is a term used to describe an anomaly in the female where a single orifice is located in the perineum draining both urogenital and gastrointestinal tracts. Few reports used the same term “cloaca” to describe the counterpart anomaly in the male. We present two “male” cases of anorectal anomalies associated with significant penile deformity (caudally displaced penis) that were managed during the period between January 2010 and September 2021. Characteristically, both cases had a single “central” perineal orifice. The latter was located anterior to the predestined site of the normal anus and just beneath a caudally positioned hypospadiac phallus. The caudal displacement of the penis was strikingly obvious by the presence of severe form of penoscrotal transposition. Both cases were associated with a perineal swelling (hamartoma) just beside the central perineal orifice. The urethra was very short (like that in the female), besides the single perineal orifice, which makes the presentation very similar to cloacal anomalies.

Keywords

cloacal variant - anorectal malformation - penoscrotal transposition - UroRectal Septum - UroRectal septum malformation sequence


Publication History

Received: 25 October 2021

Accepted: 02 March 2022

Article published online:
27 July 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Murphy F, Puri P, Hutson JM, Holschneider AM. Incidence and frequency of different types, and classification of anorectal malformations. In: Holschneider AM, Hutson JM. eds. Anorectal Malformations in Children. Berlin: Springer-Verlag; 2006: 163-182
    Google Scholar
  • 2 AbouZeid AA, Mohammad SA, Ibrahim SH, ElDieb LR. Anorectal anomalies in the male: revisiting the radiological classification. Ann Pediatr Surg 2020; 16: 42 DOI: 10.1186/s43159-020-00054-8.
    CrossrefPubMedGoogle Scholar
  • 3 Holschneider A, Hutson J, Peña A. et al. Preliminary reports on the international conference for the developement of standards for the treatment of anorectal malformations. J Pediatr Surg 2005; 40 (10) 1521-1526
    CrossrefPubMedGoogle Scholar
  • 4 Sharma S, Gupta DK. Male cloaca malformation: rare variant of anorectal malformation. Pediatr Surg Int 2015; 31 (08) 747-752
    CrossrefPubMedGoogle Scholar
  • 5 Chatterjee SK, Basu AK, Chatterjee US. Rectourinary perineal fistula–a unique anomaly. J Pediatr Surg 2005; 40 (10) 1658-1661
    CrossrefPubMedGoogle Scholar
  • 6 Banu T, Chowdhury TK, Hoque M, Rahman MAM. Cloacal malformation variants in male. Pediatr Surg Int 2013; 29 (07) 677-682
    CrossrefPubMedGoogle Scholar
  • 7 Chien JC, Chen SJ, Tiu CM, Chen YJ, Hwang B, Niu DM. Is urorectal septum malformation sequence a variant of the vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia association? Report of a case and a review of the literature. Eur J Pediatr 2005; 164 (06) 350-354
    CrossrefPubMedGoogle Scholar
  • 8 Gangopadhyayl AN, Biswasl SK, Khanna S. Exstrophy of the urorectal septum - report of two cases and embryological review. Pediatr Surg Int 1992; 7: 311-313
    CrossrefPubMedGoogle Scholar
  • 9 Rodin DM, Koh CJ, Retik AB. Sacral ectopic phallus in a case of extreme penoscrotal transposition and bladder agenesis. J Pediatr Urol 2006; 2 (01) 55-58
    CrossrefPubMedGoogle Scholar
  • 10 Kluth D, Fiegel HC, Geyer C, Metzger R. Embryology of the distal urethra and external genitals. Semin Pediatr Surg 2011; 20 (03) 176-187
    CrossrefPubMedGoogle Scholar
  • 11 AbouZeid AA, Mohammad SA, Shokry SS, El-Naggar O. Posterior cloaca: a urogenital rather than anorectal anomaly. J Pediatr Urol 2021; 17 (03) 410.e1-410.e7
    CrossrefPubMedGoogle Scholar
  • 12 AbouZeid AA, Mohammad SA. The cloacal anomalies: anatomical insights through a complex spectrum. J Pediatr Surg 2019; 54 (10) 2004-2011
    CrossrefPubMedGoogle Scholar
  • 13 Wheeler PG, Weaver DD, Obeime MO, Vance GH, Bull MJ, Escobar LF. Urorectal septum malformation sequence: report of thirteen additional cases and review of the literature. Am J Med Genet 1997; 73 (04) 456-462
    CrossrefPubMedGoogle Scholar
  • 14 Wheeler PG, Weaver DD. Partial urorectal septum malformation sequence: a report of 25 cases. Am J Med Genet 2001; 103 (02) 99-105
    CrossrefPubMedGoogle Scholar