What is a cloaca?

Early in the development of a female fetus, the tissue that is supposed to become the intestinal, genital, and urinary tracts are together in one unit known as a “cloaca.” These three typically separate as a pregnancy proceeds, creating the anus, the vagina, and the urethra.

In rare cases (1 in every 50,000 babies), this process does not work properly and these tracts do not separate from one another completely. A female is said to have developed a “persistent cloaca” when these three tracts open into one common cavity, with one opening from the body.

Normal Anatomy

Anatomy With Cloacal Malformation

What does a cloaca look like?

The appearance of the cloaca depends on where and how the three tracts are merged.

If they come together at a “low point,” the baby does not have a visible anus (opening where feces leave the body). However, everything else looks normal. While the tracts drain from the body via a common channel, the channel is usually short, allowing waste to leave freely and not infect any other tissue.

In more complicated cases, the three tracts come together at a “high point.” In these cases, the common channel is long. For this reason, getting waste to leave the body is more difficult. Urinary tract infections are common in these types of infants.

Patients with cloacal malformations may have other problems as well, including having a clitoris that looks like a penis. The vagina may be blocked, the anus may have an odd shape, and there may be more than one vagina and cervix. Some patients also have problems with the heart, spinal cord, or arms and legs.

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