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Gynecologic concerns in patients with anorectal malformations
1Pediatric and Adolescent Gynecology Program, Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA. Lesley.breech@cchmc.org
Seminars in Pediatric Surgery
|March 24, 2010
Summary
Pediatric surgeons must recognize gynecologic anomalies associated with anorectal malformations (ARMs) in girls. Early diagnosis and management improve long-term reproductive health and fertility outcomes.
Area of Science:
- Pediatric Surgery
- Gynecology
- Reproductive Health
Background:
- Anorectal malformations (ARMs) are common in pediatric surgery.
- Female patients with ARMs often have associated urological and gynecologic anomalies.
- These associated anomalies can be missed if not specifically screened for.
Purpose of the Study:
- To highlight the critical association between female anorectal malformations and gynecologic anomalies.
- To emphasize the importance of recognizing and managing these co-occurring conditions.
- To inform surgical and counseling strategies for optimal long-term patient care.
Main Methods:
- Review of common anorectal malformations in females.
- Discussion of associated gynecologic anomalies.
- Consideration of long-term sequelae and reproductive health.
Main Results:
- The most common ARM in females is imperforate anus with rectovestibular fistula.
- Cloacal malformations present the most complex anorectal defects with significant associated anomalies.
- Failure to recognize these associations can lead to missed diagnostic and treatment opportunities.
Conclusions:
- Pediatric surgeons must be aware of associated gynecologic anomalies in patients with ARMs.
- Comprehensive management requires collaboration between pediatric surgeons and gynecologists.
- Early recognition and management are crucial for addressing infancy, puberty, sexual intimacy, and obstetrical concerns, preserving future fertility.
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