A Multidisciplinary Perspective on the Evaluation and Management of the Müllerian System with Attention to Urologic...

To perform a detailed review of the current literature on management of the müllerian system with an understanding of urologic considerations in patients with persistent cloaca.

Recent literature has emphasized the co-occurrence of müllerian and urologic anomalies in children with persistent cloaca emphasizing their shared embryologic origins. Review of imaging approaches has emphasized the difficulty in accurately delineating müllerian anatomy pre-pubertally and the importance of follow-up for management of potential sequelae arising pubertally. Important aspects of care are changing such as a shift to using CIC for management of hydrocolpos as well as differing approaches to reconstruction such as timing of vaginal replacement and use of graft materials. However, high-quality literature to guide management of these critical aspects of care are lacking. The müllerian and urologic systems are essential to consider throughout childhood to preserve renal function, maximize reproductive potential and improve quality of life. High-quality studies are needed to guide evidence-based practice.