Renal Outcome in Patients With Cloaca

Warne, S.A.; Wilcox, Duncan T.; Ledermann, Sarah; Ransley, P. G.

doi:10.1016/s0022-5347(05)65034-3

Cited by 71 publications

(31 citation statements)

References 15 publications

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“…Renal impairment causes serious morbidity and there was an overall mortality rate of 6% from renal failure in this series 17. Patients with structural abnormalities, particularly renal dysplasia, solitary kidney and vesicoureteric reflux, were more likely to develop chronic renal failure 17. The importance of the early recognition and management of chronic renal failure cannot be overemphasised.…”

Section: Discussionmentioning

confidence: 77%

“…In one large retrospective review, half of the cohort had chronic renal failure by 5.7 years of age, which became end stage requiring renal transplantation in 19% 11. Renal impairment causes serious morbidity and there was an overall mortality rate of 6% from renal failure in this series 17. Patients with structural abnormalities, particularly renal dysplasia, solitary kidney and vesicoureteric reflux, were more likely to develop chronic renal failure 17.…”

Section: Discussionmentioning

confidence: 85%

“…Structural abnormalities of the kidney are common in cloaca patients and are diagnosed in around 60% of patients at presentation 17 19. Renal dysplasia, duplex systems, pelvi-ureteric junction obstruction and renal ectopia are the most frequently encountered anomalies 1 19 23…”

Section: Discussionmentioning

confidence: 99%

“…In new cloaca patients, it is important to relieve urinary tract obstruction early, prevent urinary tract infection and treat bladder dysfunction, thus dealing with the main preventable causes of renal deterioration 7 17. Untreated hydronephrosis or hypertension may cause a further decrease in renal function 17…”

Section: Discussionmentioning

confidence: 99%

“…This will be important when planning reconstructive surgery, and also as a baseline for comparison in the future (figure 4). 17…”

Section: Early Infancymentioning

confidence: 99%

See 4 more Smart Citations

Understanding cloacal anomalies

Warne

Hiorns

Curry

et al. 2011

Archives of Disease in Childhood

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Persistent cloaco is the most severe type of anorectal malformation encountered in children. Patients with cloacal anomalies have a high incidence of associated anomalies most commonly: urinary tract and spinal. Persistent cloaca remains a difficult reconstructive challenge but it is now possible to anatomically correct the defect with surgery in the majority of patients. This review discusses embryology, prenatal diagnosis, neonatal physical and radiological findings. A summary of early management and investigation is provided and the commonest surgical reconstruction techniques are discussed. The main goals of surgical reconstruction are the achievement of bowel and bladder control for the child and normal sexual function in adult life. Although the majority of cloaca patients can achieve faecal and urinary continence with the surgical reconstructive procedures performed today, many require additional/multiple urological procedures to achieve continence, treat bladder dysfunction and to protect renal function. One half of patients will develop renal failure, so regular and life long surveillance is mandatory. Due to the high number of associated gynaecological problems all patients should be assessed by a paediatric gynaecologist at puberty.

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Section: Discussionmentioning

confidence: 77%