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19–22 APRIL, 2017, BARCELONA, SPAIN
15:45–15:47
S3-6 (CP)
CT UROGRAPHY COMBINED WITH CLOACOGRAPHY
IN DIAGNOSIS OF COMPLICATED UROGENITAL
MALFORMATIONS
Karina FELBERG
1
, Malgorzata BAKA-OSTROWSKA
1
and Andrzej KOSCIESZA
2
1) Children’s Memorial Health Institute, Department of Pediatric Urology, Warsaw, POLAND - 2) Children’s Memorial
Health Institute, Department of Radiology, Warsaw, POLAND
PURPOSE
To show the use of CT urography combined with cloacography in diagnosis of complicated urogeni-
tal malformations.
MATERIAL AND METHODS
We performed CT urography with CT cloacography in two patients with persistent cloaca and one
with atypical malformation - urogenital sinus with sino-rectal fistula.
First patient presented with a 5 cm long and thin cloacal channel which did not allow to perform
cloacoscopy. CT performed together with infusion of contrast medium to the cloacal channel al-
lowed to show exact anatomy of the malformation. Cloacal channel was entering the bladder, close
to the bladder neck on the 12 hour was the opening of the incompletely duplicated vagina and the
intestine was connected to the top of the vagina between duplicated uteruses.
Second patient had prenatal shunting of the bladder. Postnataly there was no visible cloacal
opening on the perineum. CT urography and cloacography showed atypical malformation: central
cystern, connected to duplicated bladders, duplicated vaginas and intestine were also opening to
the central cystern.
Third patient was also shunted prenatally. Postnatal evaluation showed ambigus genitalia with
megalourethra and normal anus. CT urography with infusion of the contrast medium to the urogeni-
tal sinus showed duplication of the vagina and a fistula to the rectum.
RESULTS
In the first patient cloacal channel was left as a urethra, to connect the vagina with the perineum ileal
segment was used and vesicostomy was done in the sam procedure.
In the second patient two bladders were connected and vesicostomy was done. The central cystern
was remodelled and formed in a tube to connect the vaginas with the perineum.
In the third patient reconstruction of the urogenital sinus was done with the closure of the fistula.
CONCLUSIONS
CT urography combined with CT cloacography allows to show exact anatomy of atypical urogenital
malformations and better plannig of the reconstructive surgery.