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Post-pubertal gynecologic evaluation and management of patients with anorectal malformations

Kate McCracken1, Hira Ahmad2, Andrea Badillo3

  • 1Pediatric and Adolescent Gynecology Section, Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, MI, USA.

Journal of Pediatric Surgery
|July 13, 2026
PubMed

Insights

This article outlines essential gynecologic care for patients with anorectal malformations during puberty. It details pubertal development, necessary evaluations, and management strategies, including menstrual suppression and surgical options.

Area of Science:

  • Pediatric Gynecology
  • Congenital Anomalies
  • Reproductive Health

Background:

  • Anorectal malformations (ARMs) can present with associated urologic and gynecologic anomalies.
  • Congenital colorectal and pelvic disorders significantly impact quality of life.
  • The Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) addresses these complex conditions.

Purpose of the Study:

  • To review pubertal trajectory and gynecologic evaluation in patients with ARMs.
  • To provide guidance on managing gynecologic structures throughout puberty.
  • To inform clinical practice regarding menstrual and reproductive function in this population.

Main Methods:

  • Review of the literature and clinical expertise from the PCPLC Gynecology Committee.
  • Development of five consensus statements on gynecologic care for patients with ARMs.
  • Focus on pubertal development and its impact on gynecologic structures.

Main Results:

  • Puberty is a critical period for the development of Müllerian structures and identification of anomalies.
  • Gynecologic management may range from counseling to menstrual suppression or operative intervention.
  • Early and ongoing evaluation is crucial for optimizing reproductive health outcomes.

Conclusions:

  • Comprehensive gynecologic care is essential for individuals with ARMs throughout their lives.
  • Management strategies must be tailored to individual patient needs during puberty.
  • This review provides a framework for addressing pubertal gynecologic issues in patients with ARMs.

Keywords:
Anorectal malformationsMenstrual obstructionMüllerian anomaliesPuberty

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