Treatment of cloacas

Persistent cloaca was, in the past, considered an unusual defect, with a high incidence of rectovaginal fistula reported in the literature. In retrospect, it seems that cloaca represents a much more common defect in female patients than previously thought, and rectovaginal fistula is an almost nonexistent defect that is present in fewer than 1% of all cases, except in a few specific geographical areas. Most patients suffering from a persistent cloaca were erroneously thought to have a rectovaginal fistula. Many of those patients underwent surgery with repair of the rectal component only and were left with the urogenital sinus untouched, requiring a complete redo operation.