Figure 4.

Intraoperative findings during partial urogenital mobilization, 17 months old. (a) Balloon catheters in the bladder and in the rectocutaneous fistula. (b) Surgical planning and initial dissection using a posterior omega flap and a posterior midline incision of the orifice of the cloaca. (c–f) The posterior wall of the persistent urogenital sinus is opened ventrally until the perineal flap is able to reach it. The opened sinus is sewn to the perineal flap. Both sides of the incised sinus are sewn to the skin (white arrow, pubovaginalis muscle at the perineal body).