ABSTRACT
A 5-year-old female with a history of cloaca consisting of a 2 cm common channel and 1 cm urethra presents for evaluation of urinary incontinence. As an infant she underwent posterior sagittal anorectovaginourethroplasty (PSARVUP) with separation of her vagina from her urethra (urogenital separation) and interposition of bowel (left colon) from her native vagina to her perineum. She is interested in toilet training and shows the ability to generate a stream and urinate on command. She will, however, have dribbling between volitional voiding. She has not had any urinary tract infections. A renal ultrasound is normal. An MRI of her spine is normal. She underwent video urodynamics that show a large capacity, compliant bladder without overactivity.
