Long-term management of adult patients with persistent cloaca from adolescence to adulthood.

PURPOSE: This study aimed to investigate the management of patients with persistent cloaca from adolescence to adulthood. METHODS: We retrospectively reviewed 21 adult patients with persistent cloaca and investigated their urinary and bowel management, menstrual status, and sexual function during adolescence and adulthood. RESULTS: The median age at the last follow-up was 23 years (range: 18-38 years). Antegrade continence enema, irrigation, and stoma were performed in 12 patients (57%) during both adolescence and adulthood. Clean intermittent catheterization via the urethra, vesicostomy, or catheterizable channel was performed in 10 patients (48%) during both periods. In adulthood, two patients (10%) experienced soiling and all the patients, excluding one patient with severe intellectual disability, achieved urinary continence. Surgical interventions for menstrual outflow obstruction and for sexual function were performed for four patients (19%) during adolescence and seven patients (33%) during adulthood, respectively. Vaginal patency was confirmed in seven patients (33%) by pelvic examination. One patient delivered two children via cesarean section. CONCLUSION: Multidisciplinary long-term management for patients with persistent cloaca is crucial to enable them to achieve a better quality of life.