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Gynecological anomalies in patients with anorectal malformations

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Abstract

Purpose

The association of gynecological anomalies in all anorectal malformations (ARM) is firmly established. Our goal is to study this pathology in our patients to focus attention to this important issue.

Methods

Retrospective study of female patients operated for ARM and who underwent magnetic resonance imaging in our center. The type of malformation, the presence and type of vaginal, uterine, tubaric and urological anomalies were studied.

Results

63 patients were included: 34.9% cloaca, 28.6% vestibular and 12.7% perineal. Half of patients had some type of müllerian anomaly; 19 vaginal, most frequent being the longitudinal vaginal septum (66.7%); 30 had uterine alterations, most frequent being the uterus didelphys (60%). Eighty percent of patients with complex ARM (cloaca, exstrophy) presented some type of gynecological malformation compared to 21.8% found in simple ARM (stenosis, perineal, vestibular) (p < 0.001). Vaginal anomalies are associated with a uterine anomaly in 100% of cases. Conversely, patients with uterine anomalies have concurrent vaginal anomaly in 63.3% of cases.

Conclusion

Screening for gynecological anomalies is indicated in all patients with ARM. We recommend a vaginal examination in any girl with ARM during definitive repair and a subsequent MRI during follow-up. Collaboration with a gynecologist is essential.

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Author information

Authors and Affiliations

  1. Pediatric Surgery Department, Gregorio Marañón University Hospital, Madrid, Spain

    María Fanjul, Esther Molina & Julio Cerdá

  2. Pediatric Radiology Department, Gregorio Marañón University Hospital, Madrid, Spain

    Angel Lancharro

Authors
  1. María Fanjul
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  2. Angel Lancharro
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  3. Esther Molina
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  4. Julio Cerdá
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Contributions

MF, AL and EM conceived the idea. MF and AL drafted the database, which was further completed with the contribution of all other authors. MF wrote a first draft of the introduction and of the results. MF, AL, EM and JC wrote the discussion and contributed to shape the final version of the manuscript.

Corresponding author

Correspondence to María Fanjul.

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The authors declare that they have no conflict of interest.

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Fanjul, M., Lancharro, A., Molina, E. et al. Gynecological anomalies in patients with anorectal malformations. Pediatr Surg Int 35, 967–970 (2019). https://doi.org/10.1007/s00383-019-04513-1

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  • DOI: https://doi.org/10.1007/s00383-019-04513-1

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