PMC10028276_01
Images of distal loopogram (A) and endoscopy (B). Distal loopogram revealing the fistula location and spatial relationship between each cloacal structure. Loopography provides limited information on the exact size or location of individual structures. Similarly, endoscopy alone is unable to accurately determine the size or position of individual structures. This schematic based on endoscopic findings demonstrates the limitations of endoscopy.
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F1
Endoscopy revealed a common channel length of 35 mm and a short urethra with a length of 9 mm (Figure 1B).
Three-dimensional (3D) reconstruction images (A,B) and printing (C) of the cloaca in the present case.. Each structure (A,B) and their spatial relationship in the pelvic cavity (C) can be identified using 3D reconstruction. The length measured from 3D reconstruction was compared that measured by endoscopy. Urogenital separation was performed based on common channel and urethral lengths determined from 3D reconstruction images. 3D reconstruction images suggested the requirement for vaginal reconstruction. Thus, vaginal substitution using a dilated rectum was performed.
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F2
Three-D reconstruction was performed to determine the size of the pelvic structures based on the outer wall of each luminal organ (Figure 2).