October 10, 2025Oct 10 quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth -"When a baby is born with cloaca, the surgeon must keep in mind that approximately 50% of these patients suffer from a very giant vagina full of fluid (“hydrocolpos”). The hydrocolpos may compress the trigone, interfering with the drainage of the ureters and therefore provoke bilateral megaureters and hydronephrosis. All babies with a cloaca should have a complete urologic evaluation at birth, including an ultrasound of the kidneys and ultrasound of the pelvis. The baby should not be taken to the operating room without this evaluation. If the baby suffers from hydrocolpos, it is mandatory that the surgeon drain the hydrocolpos at the same time that he or she opens a colostomy. Not draining a hydrocolpos may produce persistent hydronephrosis and induce an inexperienced pediatric urologist to perform ureterostomies or nephrostomies when they are not indicated. The drainage of the vagina usually takes care of the problem of hydronephrosis. Failure to drain a tense hydrocolpos also may produce infection of the vagina (pyocolpos), perforation, and sepsis."
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