Available online 27 October 2022

To improve our understanding of reproductive health and sexual function in women with cloacal malformations and other anorectal malformations (ARM).

An observational cross-sectional survey was administered to females assigned at birth aged 12 to 55 with ARM and cloacal malformations cared for at our institution. Data included age of thelarche/menarche and questions on body image, gynecologic anatomy, sexual function, and pregnancy.

Twenty-one patients responded in the ARM group and 30 in the cloacal malformation group. There were no differences in median age of thelarche/menarche in patients with ARM (11/12.5 years) compared to patients with cloacal malformation (11/12 years). Patients with ARM were more likely to have native vaginal tissue than those with cloacal malformations (n=18, 82% versus n=12, 40%. p=0.03). There were no differences between groups regarding concerns about dyspareunia and functionality of their vagina (p>0.05). Forty-two percent of patients with cloacal malformations and 30% of patients with ARM reported having been sexually active. Two patients with cloacal malformations and two with ARM reported having been pregnant. Patients with cloacal malformation reported a lower quality of life score (80.4) compared to those with ARM (87.0) (difference >4.5).

Patients with a cloacal malformation were less likely to have native vaginal tissue and reported a lower quality of life than those with ARM. Despite this, patients with a cloacal malformation had similar reproductive health and sexual function compared to patients with ARM. Our results reinforce the need for comprehensive sexual and reproductive healthcare for all women with ARM.

Cloaca

anorectal malformation

vaginal graft

dyspareunia

sexual function

pregnancy

© 2022 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.