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Medical mystery ... cloacal malformation is usually diagnosed at birth and repaired right away so that the baby has a separate urethra, vagina, and rectum. Picture: ThinkstockSource:News Limited
A US woman born with an ‘incredibly rare’ genital malformation has astounded doctors by successfully falling pregnant and giving birth.
When Brian Steixner, MD, a urologist in Atlantic City, New Jersey, was in medical school, he witnessed the “lucky” one in a million patient who became pregnant after having anal sex, the New York Post reports.
One night, a young, pregnant woman came into the emergency department complaining of spotting. While it’s relatively common for women to have light spotting during pregnancy, the blood was coming from her rectum. That—not so common.
One in a million ... the patient reported she exclusively had anal sex prior to getting pregnant. Picture: ThinkstockSource:News Limited
The woman was born with what’s called a cloacal malformation. Meaning: When she was born, she did not have a urethra, vagina, and anus. She just had one hole, called a cloaca. (Incidentally, birds have them.) The condition is incredibly rare, occurring in about one in 25,000 female live births, says Dr Steixner (and only in girls). While no one knows what causes it, it is usually diagnosed at birth and repaired right away so that the baby has a separate urethra, vagina, and rectum.
That is what happened in this woman’s case. However, something went wrong. Either the surgery was botched or in response to the trauma of surgery, her body formed a fistula (an abnormal connection between organs), and her uterus fused to her rectum. Every month she had her period rectally.
Difficult ... women born with cloacal malformation can face health problems throughout life. Picture: ThinkstockSource:Supplied
During Dr Steixner’s conversation with the woman, he says that she mentioned she exclusively had anal sex prior to getting pregnant. “It blew my mind,” he says. A few months later, she had a caesarean and the child was healthy, he says.
Dr Steixner says he does not know what happened to the woman after she had the baby. And while the case of a woman getting pregnant through anal sex due to a cloacal malformation is incredibly rare, being born with a cloaca can be incredibly difficult, even if it is repaired at birth.
“Building the walls to separate the three passages [the urethra, vagina, and rectum] is delicate work,” he says. “The longer the walls need to be built, the closer surgeons get to the urethral and anal sphincters. Some women suffer from leakage of urine and stool their entire lives. It’s a huge psychological and quality of life issue.”
For the curious. even if the urethra and anus do not work 100 per cent perfectly after cloacal repairs, everything—vagina included—does look pretty “normal.”
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