Cloacal anomalies and other urorectal septal defects in female patients: a spectrum of anatomical abnormalities.

The anatomy and management of 16 female patients with urorectal septal defects have been reviewed. The diagnosis was often confused by the anomalous appearance of the external genitalia, and the internal arrangements of the urinary tract, genital tract and lower intestinal tract were frequently bizarre and unpredictable. Because of the potential of these patients for secondary infection and sepsis, a prompt and thorough anatomical evaluation in such cases is essential. Initial treatment should be directed toward decompression of the involved organ systems and definitive reconstruction should be deferred until the child is older, at which time the emphasis should be upon a simultaneous multisystem repair performed, whenever possible, in 1 stage.