Nestor meridionalis septentrionalis). Judi Lapsley Miller/Wikimedia Commons (CC BY 4.0) Reconstruction is the next step, but the process depends on how high up the deformity is and how long the common channel is. Typically, this begins between 6 months to 1 year of age. Reconstruction involving a child with a common channel of more than 1 inch (3 centimeters) is more complex than in a child with a smaller channel. However, the goal is the same. "At the end of it if you have a separate urethra, separate vagina and a separate anus," Wood says. Although quality of life can be dramatically improved with proper reconstruction, it's really a lifelong process to treat a patient with cloacal deformation. "Many of these kids will need help with their function," Wood says, noting that the children especially need help at age 4 or 5 when it's time to focus on continence. "They're taken care of to be sure that they're clean and dry at school." The focus shifts as they approach maturity, especially when they start menstruating and becoming sexually active. Adults often also need help with fertility issues.