Hydrocolpos
Everything in the library about hydrocolpos — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Case-Based Learning
1 item
Colorectal Quiz Episode 17: Cloaca Part 1
Listen →
The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today
podcast27:32 · Jul 2026
In-Depth Reviews
3 items
Cloaca Management with Dr. Marc Levitt & Dr. Aaron Garrison
Listen →
Marc Levitt, MD discusses Cloaca with Todd Ponsky, MD and Aaron Garrison, MDEdited by Ian C Glenn, MD and Sophia Abdulhai, MDDr. Levitt is surgical director of the Center for Colorectal and Pelvic Reconstruction as well as program director
podcast43:47 · Jan 2019
Cloaca Management with Dr. Marc Levitt & Dr. Aaron Garrison
Listen →
Marc Levitt, MD discusses Cloaca with Todd Ponsky, MD and Aaron Garrison, MDEdited by Ian C Glenn, MD and Sophia Abdulhai, MDDr. Levitt is surgical director of the Center for Colorectal and Pelvic Reconstruction as well as program director
podcast43:47 · Dec 2020
ERN eUROGEN ARM Webinar Series: Management of Cloacal Malformations – what is new in 2021?
Watch →
eUROGEN ARM Webinars Series, October 2021
This webinar will be presented by Dr. Marc Levitt from the Children’s National Hospital in Washington D.C.
The management of cloacal malformations, including prenatal diagnosis, newborn trea
video48:03 · Dec 2022
Summaries and takeaways+ Show
The doctors in this collection+ Show
All expert statements+ Show
Every expert statement below comes from the recorded discussions, with its speaker and moment.
Colorectal Quiz Episode 17: Cloaca Part 1
A single perineal orifice in a newborn should clue you into a cloaca, where the vagina, urethra, and rectum are fused together inside creating a single common channel
clinicalRichard Wood2:05 ↗
Hydrocolpos is the distension of the vagina caused by the accumulation of fluid
clinicalRichard Wood2:25 ↗
A cloaca or anorectal malformation is associated with VACTERL and needs to be worked up as such
guidelineRichard Wood2:40 ↗
VACTERL association consists of vertebral anomalies, imperforate anus, cardiovascular anomalies, tracheoesophageal fistulas, esophageal atresia, renal or radial anomalies, and limb defects; three or more anomalies are needed for the association
clinicalAmanda Jensen3:10 ↗
A hydrocolpos on prenatal ultrasound should alert to the possibility of a cloaca
clinicalRichard Wood3:44 ↗
Abnormal kidneys, a single kidney, or a two-vessel cord on prenatal ultrasound can be associated with cloaca
clinicalRichard Wood4:10 ↗
The diagnostic yield for cloacal malformations on prenatal ultrasound is still much lower than desired
epidemiologicalRichard Wood3:44 ↗
In a large majority of patients with cloaca, the diagnosis is made at birth
epidemiologicalHira Ahmad5:41 ↗
Children with cloacas are female and do not need workup for karyotyping or disorders of sexual differentiation, despite potentially prominent clitoral hood and labial tissue
guidelineRichard Wood7:20 ↗
Initial workup for cloaca should consist of NG tube and chest x-ray, cardiac echo, and pelvic and renal ultrasound to assess for TEF, cardiac anomalies, hydrocolpos, and hydronephrosis
guidelineRichard Wood7:56 ↗
If bilateral hydronephrosis and hydrocolpos are present, the hydrocolpos needs to be managed as part of initial treatment
clinicalRichard Wood9:00 ↗
Modern practice has moved away from routine vaginostomy toward clean intermittent catheterization through the common channel for hydrocolpos drainage
clinicalRichard Wood9:11 ↗
To perform CIC for hydrocolpos, pass a tube through the common channel, drain fluid, confirm tube placement in the hydrocolpos with ultrasound, then perform recurrent catheterization
clinicalRichard Wood9:24 ↗
When catheterizing the common channel, you are more likely to get into the vagina than the bladder due to the anatomy of the urethral takeoff
clinicalMarc Levitt11:08 ↗
Initial catheterization should be performed with bedside ultrasound confirmation that the tube is in the hydrocolpos and is decompressing it
guidelineRichard Wood12:33 ↗
When the hydrocolpos is drained, the bladder fills, demonstrating that the hydrocolpos was obstructing the ureters
clinicalMarc Levitt13:11 ↗
A vesicostomy is the wrong move in almost every cloaca; the hydrocolpos needs to be drained instead
opinionMarc Levitt13:59 ↗
Initial catheterization frequency is three times daily, which can be reduced to twice daily when families begin performing it at home
guidelineRichard Wood15:01 ↗
Serial ultrasounds should be performed every 2-3 days initially, then stretched to weekly, to confirm adequate kidney decompression
guidelineRichard Wood15:30 ↗
After discharge, monthly ultrasounds should be performed to ensure continued kidney decompression, which can be stretched to every six weeks if doing well
guidelineRichard Wood16:00 ↗
Even with a vaginostomy tube, you must continue checking that the kidneys are decompressed, as the tube may not be doing its job
clinicalRichard Wood16:40 ↗
Colostomy should be performed as proximally as possible, at the descending-sigmoid junction, to ensure enough length for distal work
clinicalRichard Wood17:53 ↗
Laparoscopy for newborn colostomy formation provides good anatomical views of the pelvis, allows precise colostomy site selection, and avoids a wound between the two stomas
clinicalRichard Wood18:42 ↗
If a vaginostomy is needed in a patient with a vaginal septum, open the anterior wall of the hydrocolpos and remove a small portion of the septum to drain both sides through one hole
clinicalRichard Wood20:15 ↗
Vaginostomy tubes can become encrusted and colonized, so there is some advantage to tubeless vaginostomy
clinicalRichard Wood21:00 ↗
For massive hydrocolpos requiring open vaginostomy, use a lower midline incision to get above the hydrocolpos, which is very adherent to the anterior abdominal wall and inflamed
clinicalMarc Levitt21:37 ↗
A single perineal orifice with no anal opening is a cloaca and does not need an endocrine workup, whereas a perineal opening with a normal anus is a urogenital sinus and does need an endocrine workup
guidelineMarc Levitt22:51 ↗
Urogenital sinus patients can also have hydrocolpos and hydronephrosis, requiring similar management but without colostomy
clinicalMarc Levitt23:40 ↗
After initial management, follow patients closely to ensure kidneys are well decompressed, the baby is growing and thriving, and parents are managing the stoma
guidelineRichard Wood24:36 ↗
With urine and stool effectively drained, patients should be thriving unless other underlying issues are present
clinicalRichard Wood25:20 ↗
What's new+ Show