What You Need to Know About Diagnosing Cloaca

What are the diagnostic tests and tools performed to diagnose cloacal malformations?

• Ultrasound

  An abdominal ultrasound can be used to examine the kidneys, bladder and pelvic organs, while a spinal ultrasound can be used to look for spine abnormalities or other neurological problems. A pelvic and renal ultrasound can assess for hydrocolpos (enlarged vagina filled with urine), which can cause hydronephrosis (enlarged ureters which empty poorly and may damage the kidneys).

• X-rays

  X-rays can provide additional information about the spine and sacrum. They are an effective tool for assessing anomalies and determining the sacral ratio, which can help predict bowel and urinary continence. In addition, they can be used to identify hemivertebrae or other sacral anomalies.

• Voiding cystourethrogram (VCUG) and cloacagram

  These tests, which use fluoroscopy, can be used to evaluate a child’s urethra and bladder size, shape, and capacity as well as the gynecologic structures and the height of the rectum. They can check for vesicoureteral reflux (VUR), a cause of urinary tract infections, and can provide an accurate image of the common channel and urethral length.

• MRI of the spine and pelvis

  After three months of age, an MRI can provide additional information about the anatomy of a patient’s spine.

• Endoscopic examination

  An endoscopic examination, taking place after the neonatal period, allows the team to attain a more detailed anatomical understanding of the malformation. It is recommended that every patient undergo an endoscopic examination before undergoing reconstructive surgery.  At Children’s National, the colorectal, urologic and gynecologic teams join with the interventional radiology team to perform both the endoscopic investigation and the cloacagram at the same setting. Then, the entire team discusses the anatomy and plans the reconstruction.
  
  Learn more about the procedure here.