# Complications and Long-Term Outcomes of Patients With Cloacal Malformation After Bowel Neovagina... — GCMD Library

Dr. Megan Reed Ivaturi from Nationwide Children's Hospital discusses a recent study published in the Journal of Pediatric Surgery on the long-term outcomes of bowel neovagina creation for patients with cloacal malformations. The study evaluated 40 patients, comparing outcomes between small bowel and colonic neovaginas, and highlighted the importance of long-term follow-up for function, stenosis, and quality of life.

Kristine L Griffin, Wendy Jo Svetanoff, Megan A Read, Shruthi Srinivas, Geri Hewitt, Richard J Wood, Chelsea A Kebodeaux

Introduction: Up to 60 % of patients with a cloacal malformation have a Mullerian anomaly. In cases where the vagina is absent or cannot reach the perineum, an intestinal neovagina is often created. The complications and outcomes of this are not well described. We aimed to describe the gynecologic outcomes of patients who underwent neovagina creation followed at our institution.

Methods: A single institution retrospective review of patients ≥8 years old with cloacal malformation who underwent intestinal neovagina creation was performed. Demographics, surgical history, short-term complications, and long-term gynecologic outcomes were assessed.

Results: Forty patients were included. The median age at neovagina creation was 3.95 years (IQR 1.40, 7.61). Twelve patients (30 %) had uterine agenesis. Neovagina was colonic in 27 (67.5 %) and small bowel in 12 (30 %). Median age at most recent follow up was 9.7 years (IQR 7.6, 14.1). There was no difference in 30-day complications, incidence of vaginal prolapse, introital stenosis, or graft stenosis between those undergoing small bowel vs colonic neovagina. Two patients had documented menstrual obstruction, and 11 patients reported bothersome vaginal discharge. Of those with neovagina prolapse, one small bowel (8.3 %) and two colonic grafts (7.4 %) required prolapse repair. One small bowel (8.3 %) and 7 colonic (26 %) patients underwent introitoplasty for stenosis. Of the 3 patients having penetrative sex, 2 reported dyspareunia. No patients have become pregnant.

Conclusion: Bowel neovaginas remain a suitable choice for patients with cloacal malformations in whom the vagina is absent or cannot reach the perineum.

For more information, visit the Center for Colorectal and Pelvic Reconstruction (CCPR): https://www.nationwidechildrens.org/specialties/colorectal-and-pelvic-reconstruction-ccpr

Type: video · 1 min · posted 2026-06-09
Canonical: https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170

## Chapters
- [0:00](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=0) Introduction and Study Design
- [0:24](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=24) Study Findings and Complications
- [0:51](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=51) Clinical Takeaway

## Statements
- "The study was a single institution retrospective study of 40 patients with cloacal malformations who underwent bowel neovagina creation during reconstruction" — Megan Reed Evatori (clinical) [0:11](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=11)
- "Overall outcomes were similar between small bowel and colonic neovaginas" — Megan Reed Evatori (clinical) [0:25](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=25)
- "Major complications were uncommon but not negligible" — Megan Reed Evatori (clinical) [0:29](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=29)
- "Enterroidal stenosis was more common with colonic grafts" — Megan Reed Evatori (clinical) [0:32](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=32)
- "A subset of patients required roidoplasty" — Megan Reed Evatori (clinical) [0:32](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=32)
- "Vaginal prolapse was rare" — Megan Reed Evatori (clinical) [0:38](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=38)
- "Menstrual obstruction occurred in only a few patients" — Megan Reed Evatori (clinical) [0:40](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=40)
- "About 25% of patients reported bothersome discharge" — Megan Reed Evatori (clinical) [0:43](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=43)
- "Among the small number who were sexually active, dyspareunia was reported" — Megan Reed Evatori (clinical) [0:46](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=46)
- "Bowel neovaginas are a reasonable and durable option" — Megan Reed Evatori (opinion) [0:52](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=52)
- "Patients with bowel neovaginas need long term follow up with attention to function, stenosis and quality of life" — Megan Reed Evatori (guideline) [0:57](https://library.globalcastmd.com/watch/complications-and-long-term-outcomes-of-patients-with-cloacal-malformation-after-bowel-neovagina-12170?t=57)

## Transcript
Do bowel knee vaginas actually hold up long term for patients with cloacal malformations? I'm Megan Reed Evatori from the Center for Colorectal and Pelvic Reconstruction at Nationwide Children's Hospital, and this is an article you should know about. Published recently in the Journal of Pediatric Surgery, this single institution retrospective study looked at 40 patients with cloacal malformations who underwent bowel neov vagina creation during their reconstruction. The study team followed their outcomes long term. So what did they find? Overall, outcomes were similar between small bowel and colonic ne vaginas. Major complications were uncommon but not negligible. Some patients developed enterroidal stenosis, more common with colonic grafts, and a subset did require roidoplasty. Vaginal prolapse was rare. Menstrual obstruction occurred in only a few patients. About 25% of patients reported bothersome discharge. Among the small number who were sexually active, dyspunia was reported. So what is the takeaway? Bowel new vaginas are a reasonable and durable option, but they are not just set it and forget it. These patients need long term follow up with attention to function, stenosis and quality of life. How are you counseling families about these long term expectations?

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Not medical advice · citation policy: https://library.globalcastmd.com/ai