Abstract:Surgical management of the high urogenital sinus (UGS) remains challenging. Surgical management is tailored according to the anatomical characteristics of an individual case as well as the presence of coexisting genitourinary anomalies. In cases of high UGS, en bloc or total mobilization remains controversial. Some authors have proposed an approach based on posterior sagittal access for the management of persistent cloaca, with exposure obtained by midline sagittal division of posterior and anterior anorectal walls along with the corresponding sphincteric musculature. We report our experience with posterior sagittal approach in an adolescent girl with high UGS with anterior displacement of the anus.