The main goal is for the child to gain urinary and bowel control, and to be able to function sexually later in her life.
A patient who has one to three bowel movements per day, remains clean in between bowel movements, and experiences feeling or pushing during bowel movements usually has a good prognosis for bowel control. A patient with multiple bowel movements or one who is passing stool constantly without showing any signs of sensation or pushing usually has a poor chance for bowel control. The quality of the sacrum and spine are key predictors of bowel control, as is the length of the common channel.
Cloaca patients have a smooth, large bladder that often does not empty completely. Fortunately, most patients with cloacas have a good bladder neck. This combination makes them ideal candidates for intermittent catheterization, which keeps them completely dry.
In cloacas where the common channel is shorter than 3 centimeters, about one in five patients require intermittent catheterization to empty the bladder. The remaining four out of five patients have voluntary urinary control.
Further evaluations are needed as the child grows and matures. Menstruation is possible even if the vagina was reconstructed. Before the patient becomes sexually active, the vaginal opening should be evaluated for possible additional surgical repairs. In most cases, vaginal delivery of a baby is not possible and a cesarean section is required.