Children's Hospital Colorado
Colorectal and Urogenital Care


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International Center for Colorectal and Urogenital Care
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What is cloaca?

Cloaca is an anorectal malformation that affects the rectum and urogenital tract in females. Females are normally born with three perineal openings: urethra, vagina and anus. Children born with a cloaca only have one opening because the urethra, vagina and rectum are joined together as a common channel instead of three separate ones. They may also may have more than one uterus and vagina.

What are the types of cloaca?

The length of the common channel may vary between 1 cm and 10 cm. The length of the common channel affects prognosis (health outlook) and determines the type of surgery that a child will need. The shorter the common channel, the better the prognosis for bowel and urinary control will be.

Short common channel (less than 3 cm in length)

Intermediate common channel (between 3 and 5 cm)

Long common channel (more than 5 cm)

What other health problems can occur with cloaca?

  • Hydrocolpos: At birth, about 30% of infants have hydrocolpos (a distended vagina), which is caused by accumulation of fluid and/or mucus inside the vagina.
  • Urologic problems: About 50% of infants have urologic problems such as hydronephrosis, vesicoureteral reflux, an absent kidney and megaureter (enlarged ureter). Ureters are tubes that carry urine from the kidneys to the bladder.
  • Gastrointestinal problems: About 11% of infants with cloaca will have esophageal atresia and 3% will have duodenal atresia. Esophageal atresia is a condition in which the esophagus does not develop properly. Duodenal atresia is a condition in which the small bowel does not develop normally.
  • Heart problems: About 30% will have heart problems such as atrial septal defect and tetralogy of Fallot and patent ductus arteriosus. Patent ductus arteriosus is an open connection between the aorta and the pulmonary artery.
  • Spinal problems: About 25% of children will have a tethered spinal cord.

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