Total urogenital mobilization by posterior sagittal approach and ileal neovaginoplasty in cloacal repair by a common channel of 4 cm

Abstract

ObjectiveThe total urogenital mobilization (TUM) technique avoids dissection of the vagina from the urinary tract. However, in the case of a long common channel, bowel interposition for vaginal replacement may be necessary. We present a video of the TUM technique in cloacal repair with ileal neovaginoplasty. MethodsAn 8-month-old female patient with cloaca, presenting a 4-cm common channel, was operated on by the TUM technique, through a perineal sagittal with additional abdominal approach. She had undergone decompressing colostomy at birth. Total urogenital sinus mobilization was performed with ileal neovaginoplasty. ResultsThe patient had a good postoperative outcome, an endoscopy of all structures reconstructed was performed at PO day 30, and home dilatation of colon and vagina by parents was initiated. ConclusionTUM with neovaginoplasty bowel interposition is an effective technique for repairing long common channels.