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Long-term outcomes of anorectal malformations and Hirschsprung disease
Published in Alejandra Vilanova-Sánchez, Marc A. Levitt, Pediatric Colorectal and Pelvic Reconstructive Surgery, 2020
Tomas Wester, Mikko Pakarinen, Risto Rintala
Patients with cloaca commonly have urinary tract dysfunction. Urological as well as spinal and spinal cord anomalies are very common. Moreover, the extensive surgery required to repair a cloacal malformation may deteriorate the bladder function [23]. In a systematic review [18] concerning cloaca patients of all ages, urinary tract function was reported in 332 patients, pooled from nine studies. Spontaneous voiding was achieved on average by 46% (range 22%–54%) of the assessed patients. Intermittent catheterization to empty the bladder was reported by 42% of the patients (range 12%–100%) and 22% had undergone urinary diversion (range 18%–27%). Urinary incontinence was reported in 23% (range 9%–41%) of the patients.
Exstrophy-epispadias complex
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Cloacal exstrophy: 1 in 200 000 live birthsIncidence is the same for both males and females.
Radical Sphincter-Sparing Resection in Rectal Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The anorectal tube opens into a dilated pouch termed the endodermal cloaca. Initially the cloaca corresponds to a common cavity shared by the urogenital and gastrointestinal organs. The allantois enters the anterior portion of the cloaca to form the urogenital sinus, which forms part of the bladder and urethra, and the anorectal tube enters into the distal portion. The cloacal membrane is formed by the contact between the endoderm of the cloaca and the surface ectoderm. A primitive urorectal septum divides the urogenital sinus anteriorly and the anorectal canal posteriorly. The mesenchymal tissue of the uro-rectal septum grows downward and fuses with the membrane of the cloaca. This represents the primitive perineum, which later becomes the perineal body.93
Stability and Change in Sexual Orientation and Genital Arousal over Time
Published in The Journal of Sex Research, 2023
Dragos C. Gruia, Luke Holmes, Jaime Raines, Erlend Slettevold, Tuesday M. Watts-Overall, Gerulf Rieger
One hypothesis is that sexual orientation is a stable trait, which is possibly determined during early development and does not change later in life (Bogaert & Skorska, 2020; Breedlove, 2017; Farr et al., 2014). Support for this notion comes from case studies of males who had their genitals surgically removed due to a rare medical condition called cloacal exstrophy, and who were surgically re-assigned and raised as females. Despite these profound changes, the vast majority of these individuals later identified as males with attraction to females (Diamond et al., 2011; Meyer-Bahlburg, 2005; Reiner, 2004; Reiner & Gearhart, 2004; Zucker, 1999). These results suggest that at the very least, male sexual orientation is not malleable even in the face of severe social and physical manipulations. Moreover, conversion therapies, which make deliberate efforts to change male and female sexual orientation in adulthood, show little to no evidence that change is possible (Drescher et al., 2016; Haldeman, 1994). One author supported the effectiveness of reparative therapies (Spitzer, 2003); however, this has been criticized, as it was impossible to judge whether the reports of those undergoing therapy were truthful (Armelli et al., 2012; Drescher & Kenneth, 2013). Research into gender behavior also supports the idea that sexual orientation is a stable trait that forms early, since childhood gender nonconformity (femininity in males and masculinity in females) is a robust predictor of a non-heterosexual sexual orientation in adulthood (Bailey et al., 2016; Bailey & Zucker, 1995; Watts et al., 2018; Xu et al., 2021).
Spine duplication or split notochord syndrome – case report and literature review
Published in The Journal of Spinal Cord Medicine, 2020
Barbara Jasiewicz, Magdalena Stachura, Tomasz Potaczek, Slawomir Duda, Piotr Michno, Stanislaw Kwiatkowski
A male neonate weighing 2800 g was delivered at term by caesarian section. Apgar score was 1 at 1 min. His parents were unrelated, and the maternal history was uneventful. Physical examination showed defects of the abdominal wall in the underbelly, cloacal exstrophy with visible urether outlets. The penis and the scrotum were transposed to the right. A narrow fistula or transposed anus, with stool passing through it, was present in the perineal region. Further investigation revealed a normal left kidney and ectopis right . At the back, split bony elements of the spine with nonpalpable sacral bone were noted. A soft, skin-covered lump, with the consistency of a lipoma, was present in the sacral area. There was asymmetry of the lower limbs: the right lower limb had a normal shape and range of motion of the joints, whereas the left lower limb was hypoplastic, with a deformed foot and limited active and passive motions (flaccid paresis from the level of L4). Beginning at the first month of life, the patient underwent several surgeries because of urogenital and gastrointestinal defects.
Difference between right-sided and left-sided colorectal cancers: from embryology to molecular subtype
Published in Expert Review of Anticancer Therapy, 2018
Seung Yoon Yang, Min Soo Cho, Nam Kyu Kim
The endodermal gut tube created by body folding during the fourth week of gestation consists of a blind-ended cranial foregut, a blind-ended caudal hindgut, and a midgut open to the yolk sac through the vitelline duct [11]. The midgut forms the distal duodenum, jejunum, ileum, cecum, ascending colon, and proximal two-thirds of the transverse colon. The hindgut forms the distal third of the transverse colon, the descending and sigmoid colon, and the upper two-thirds of the anorectal canal. Just superior to the cloacal membrane, the primitive gut tube forms an expansion called the cloaca. During the fourth to sixth weeks, a coronal urorectal septum partitions the cloaca into the urogenital sinus, which will give rise to urogenital structures, and a dorsal anorectal canal [12]. As the right and left sides of the colon derive from different embryologic origins, anatomically, the proximal colon receives its main blood supply from the superior mesenteric artery with its capillary network being multilayered. The distal colon is perfused by the inferior mesentery artery. Between these two main sources, there is a watershed area located just proximal to the splenic flexure where branches of the left branch of the middle colic artery anastomose with those of the left colic artery. This area represents the border of the embryologic midgut and hindgut. Venous drainage of the colon largely follows the arterial supply with superior and inferior mesenteric veins draining both the right and left halves of the colon.