When a female baby is born with a cloacal malformation, the body’s systems for digestion, urination, and reproduction come together into one shared tract. Instead of having separate openings for the rectum, urethra, and vagina, there is just one opening.
Cloacal malformation is rare and can vary in severity. It can cause problems with going to the bathroom and may affect reproductive health later on.
Surgery is usually needed to help restore each system’s natural function and give your child the best chance at a healthy future.
Signs of cloacal malformation often appear after birth. You or your child’s doctor may notice that your baby doesn’t pass stool or urine as expected. Sometimes there’s swelling in the belly, or a single opening where there should be more than one.
Over time, children may also have trouble with bladder or bowel control. Every child is different, but early symptoms are often a sign that testing is needed to understand the severity of the condition. If you think your baby may have cloacal malformation, schedule an appointment with your pediatrician.
CHRISTUS Children's General Surgery Clinic in San Antonio provides exceptional surgical care for infants, children, and teens.
When your child needs care for a cloacal malformation, you deserve a team that sees the whole picture — and the whole child. That means caring for more than one system at a time. It means staying with you, from the first questions to the last follow-up.
At CHRISTUS Children’s, specialists in pediatric surgery, urology, gynecology, and gastroenterology come together to create one care plan — shaped just for your child. Nutrition, bowel care, and healing are all connected here.
And so are you. Every step includes guidance, answers, and support from a team that knows this path and walks it with families every day.
Most cases of cloacal malformation are diagnosed soon after birth, especially if your baby isn’t passing urine or stool. Your doctor may use imaging tests to understand how the urinary, digestive, and reproductive systems are connected. Sometimes, more detailed studies are needed as your child grows. These tests help the care team plan the safest, most effective treatment for your child.
Every child’s needs and anatomy are different, so the first step is often imaging and gentle exams to learn how the organs are connected.
Many babies will need a temporary colostomy soon after birth to help them pass stool safely while the body heals and grows. A colostomy is a surgery that helps your baby pass stool by creating a small opening in the belly, where waste leaves the body into a bag. This is temporary, giving the body time to heal before reconstructive surgeries.
The long-term outcomes for children with cloacal malformations have improved significantly with advances in surgical techniques and aftercare:
It is important for you, as parents and caregivers, to work closely with your child's health care team. This will help ensure the best outcomes for your child.
The primary surgery to fix a cloacal malformation is known as a Posterior Sagittal Anorectal Vaginalplasty, or PSARVUP. This surgery aims to separate the three channels—rectum, urethra and vagina—and create individual openings for each.
Steps of the surgery:
The procedure may require one or multiple stages, depending on the complexity of the malformation.
Posterior Sagittal Anorectal Vaginal Urethral Plasty, or PSARVUP, is the primary surgery used to repair cloacal malformations. It is a detailed procedure designed to give each organ its own healthy, working pathway.
Here’s a step-by-step of what happens during the PSARVUP surgery:
Anesthesia and Positioning
Creating the Surgical Opening
Separating the Organs
Rebuilding the Openings
Closing the Incision
