Abstract：
BACKGROUND: Multiple factors impact ability to achieve urinary continence in cloacal malformation including common channel (CC) and urethral length and presence of spinal cord abnormalities. Few publications describe continence rates and bladder management in this population. We evaluated our cohort of patients with cloacal malformation to describe the bladder management and continence outcomes.
METHODS: We reviewed a prospectively collected database of patients with cloacal malformation managed at our institution. We included girls ≥3 years (y) of age and evaluated their bladder management methods and continence. Dryness was defined as <1 daytime accident per week. Incontinent diversions with both vesicostomy and enterovesicostomy were considered wet.
RESULTS: A total of 152 patients were included. Overall, 93 (61.2%) are dry. Nearly half (47%) voided via urethra, 65% of whom were dry. Twenty patients (13.1%) had incontinent diversions. Over 40% of the cohort performed clean intermittent catheterization (CIC), approximately half via urethra and half via abdominal channel. Over 80% of those performing CIC were dry. In total, 12.5% (n = 19) required bladder augmentation (BA). CC length was not associated with dryness (p = 0.076), need for CIC (p = 0.253), or need for abdominal channel (p = 0.497). The presence of a spinal cord abnormality was associated with need for CIC (p = 0.0117) and normal spine associated with ability to void and be dry (p = 0.004) CONCLUSIONS: In girls ≥ 3 y of age with cloacal malformation, 61.2% are dry, 65% by voiding via urethra and 82% with CIC. 12.5% require BA. Further investigation is needed to determine anatomic findings associated with urinary outcomes.
METHODS: IV.
METHODS: We reviewed a prospectively collected database of patients with cloacal malformation managed at our institution. We included girls ≥3 years (y) of age and evaluated their bladder management methods and continence. Dryness was defined as <1 daytime accident per week. Incontinent diversions with both vesicostomy and enterovesicostomy were considered wet.
RESULTS: A total of 152 patients were included. Overall, 93 (61.2%) are dry. Nearly half (47%) voided via urethra, 65% of whom were dry. Twenty patients (13.1%) had incontinent diversions. Over 40% of the cohort performed clean intermittent catheterization (CIC), approximately half via urethra and half via abdominal channel. Over 80% of those performing CIC were dry. In total, 12.5% (n = 19) required bladder augmentation (BA). CC length was not associated with dryness (p = 0.076), need for CIC (p = 0.253), or need for abdominal channel (p = 0.497). The presence of a spinal cord abnormality was associated with need for CIC (p = 0.0117) and normal spine associated with ability to void and be dry (p = 0.004) CONCLUSIONS: In girls ≥ 3 y of age with cloacal malformation, 61.2% are dry, 65% by voiding via urethra and 82% with CIC. 12.5% require BA. Further investigation is needed to determine anatomic findings associated with urinary outcomes.
METHODS: IV.
摘要：
背景：多种因素影响泄殖腔畸形患者实现尿失禁的能力，包括共同通道（CC）和尿道长度以及脊髓异常的存在。很少有出版物描述该人群的节制率和膀胱管理。我们评估了我们的泄殖腔畸形患者队列，以描述膀胱管理和节制结果。
方法：我们回顾了前瞻性收集的在我们机构管理的泄殖腔畸形患者数据库。我们纳入了年龄≥3岁（y）的女孩，并评估了她们的膀胱管理方法和节制。干燥定义为每周<1次白天事故。膀胱造口术和肠膀胱造口术的失禁转移被认为是湿的。
结果：共纳入152例患者。总的来说,93（61.2％）是干的。近一半（47%）通过尿道排尿，其中65%是干的。20例患者（13.1％）出现失禁转移。超过40％的队列进行了清洁间歇性导管插入术（CIC），大约一半通过尿道，一半通过腹部通道。超过80%的进行CIC的是干的。总的来说,12.5％（n=19）需要膀胱扩张（BA）。CC长度与干燥度无关（p=0.076），需要CIC(p=0.253)，或需要腹部通道（p=0.497）。脊髓异常的存在与对CIC的需求相关（p=0.0117），正常脊柱与空缺和干燥能力相关（p=0.004）结论：在年龄≥3岁的泄殖腔畸形女孩中，61.2%是干的，65％通过尿道排尿，82％与CIC。12.5%需要BA。需要进一步的研究来确定与泌尿结果相关的解剖学发现。
方法：IV.
方法：我们回顾了前瞻性收集的在我们机构管理的泄殖腔畸形患者数据库。我们纳入了年龄≥3岁（y）的女孩，并评估了她们的膀胱管理方法和节制。干燥定义为每周<1次白天事故。膀胱造口术和肠膀胱造口术的失禁转移被认为是湿的。
结果：共纳入152例患者。总的来说,93（61.2％）是干的。近一半（47%）通过尿道排尿，其中65%是干的。20例患者（13.1％）出现失禁转移。超过40％的队列进行了清洁间歇性导管插入术（CIC），大约一半通过尿道，一半通过腹部通道。超过80%的进行CIC的是干的。总的来说,12.5％（n=19）需要膀胱扩张（BA）。CC长度与干燥度无关（p=0.076），需要CIC(p=0.253)，或需要腹部通道（p=0.497）。脊髓异常的存在与对CIC的需求相关（p=0.0117），正常脊柱与空缺和干燥能力相关（p=0.004）结论：在年龄≥3岁的泄殖腔畸形女孩中，61.2%是干的，65％通过尿道排尿，82％与CIC。12.5%需要BA。需要进一步的研究来确定与泌尿结果相关的解剖学发现。
方法：IV.
