الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Introduction: Persistence of a common urogenital sinus can occur as an isolated anomaly or as a part of other condition such as congenital adrenal hyperplasia and cloacal malformations. Surgical repair of these anomalies aims at separation of the urinary and genital tracts and creation of a normal vaginal introitus with reconstruction of good cosmetic feminine external genitalia. Total urogenital mobilization developed to avoid dissection in the common wall between vagina and urethra.
Patients and methods: This study included 25 cases underwent TUM. These cases were divided into 2 groups. The first group included 14 cases diagnosed as CAH whereas 11 cases of persistent cloaca were included in the second group. The outcome of TUM was evaluated by assessment of the cosmetic outcome, clinical evaluation of the urethral and vaginal opennings in addition to the neorectum in cloacal anomalies, and estimation of the impact on urinary and fecal continence by Peña scoring system.
Results: Flush retrograde genitogram or cloacogram is a good investigation for determining the site of cnfluence between the urethra and the vagina with a sensitivity of 100% and in estimating the length of the common channel with 67.1% sensitivity in patients with CAH versus 88.9% in patients with cloacal anomalies. Overall complications rate in this study was 28.6% in the group of CAH versus 36.4% in the group of cloacal anomalies. Hoewver, all complications could be managed by simple maneuvers like regular vaginal dilatation. There is no adverse effects on urinary continence after TUM and both urinary and fecal continence are related to the degree of sacral deficiency more than to the length of common channel.
Conclusion: Total Urogenital Mobilization is an innovative technique that make separation of urethra from vagina an easier task with less operative time and less complications.