Abstract：
OBJECTIVE: Mullerian duct anomalies are common in females with anorectal malformations (ARMs), although there are no universally recommended screening protocols for identification. Historically, at our institution, we have recommended a screening pelvic ultrasound (PUS) 6 months after thelarche and menarche. We aimed to evaluate outcomes associated with our post-thelarche screening PUS in females with ARMs.
METHODS: An institutional review board-approved retrospective chart review was performed for all female patients 8 years old or older with ARMs and documented thelarche. Data were collected on demographic characteristics and clinical course. The primary outcome was adherence to the recommended PUS. Secondary outcomes included imaging correlation with suspected Mullerian anatomy and need for intervention on the basis of imaging findings.
RESULTS: A total of 112 patients met the inclusion criteria. Of them, 87 (77.7%) completed a recommended post-thelarche screening PUS. There were no differences in completion on the basis of age, race, establishment with a primary care provider, insurance status, or type of ARM. Nine patients (10.3%) had findings on their PUS that did not correlate with their suspected Mullerian anatomy; five (5.7%) required intervention, with two requiring menstrual suppression, two requiring surgical intervention, and one requiring further imaging.
CONCLUSIONS: Most patients completed the recommended post-thelarche screening PUS. In a small subset of patients, PUS did not correlate with suspected Mullerian anatomy and generated a need for intervention. Post-thelarche PUS can be a useful adjunct in patients with ARMs to identify gynecologic abnormalities.
METHODS: An institutional review board-approved retrospective chart review was performed for all female patients 8 years old or older with ARMs and documented thelarche. Data were collected on demographic characteristics and clinical course. The primary outcome was adherence to the recommended PUS. Secondary outcomes included imaging correlation with suspected Mullerian anatomy and need for intervention on the basis of imaging findings.
RESULTS: A total of 112 patients met the inclusion criteria. Of them, 87 (77.7%) completed a recommended post-thelarche screening PUS. There were no differences in completion on the basis of age, race, establishment with a primary care provider, insurance status, or type of ARM. Nine patients (10.3%) had findings on their PUS that did not correlate with their suspected Mullerian anatomy; five (5.7%) required intervention, with two requiring menstrual suppression, two requiring surgical intervention, and one requiring further imaging.
CONCLUSIONS: Most patients completed the recommended post-thelarche screening PUS. In a small subset of patients, PUS did not correlate with suspected Mullerian anatomy and generated a need for intervention. Post-thelarche PUS can be a useful adjunct in patients with ARMs to identify gynecologic abnormalities.
摘要：
目的：Mullerian导管异常常见于患有肛门直肠畸形（ARM）的女性，尽管没有普遍推荐的识别筛查方案。历史上,在我们的机构，我们建议在初潮和初潮后六个月进行盆腔超声筛查。我们的目的是评估与我们在ARM女性患者中进行后筛查盆腔超声（PUS）相关的结果。
方法：对所有≥8岁的ARM患者进行了IRB批准的回顾性图表回顾，并记录了该病例。收集有关人口统计学和临床过程的数据。主要结果是坚持推荐的PUS。次要结果包括与疑似Mullerian解剖结构的影像学相关性以及基于影像学发现的干预需求。
结果：总共112例患者符合纳入标准。其中,87（77.7％）完成了推荐的后筛查PUS。根据年龄，完成学业没有差异，种族,与初级保健提供者建立，保险状况,或ARM的类型。9例患者（10.3％）的PUS发现与他们怀疑的苗勒氏解剖结构无关；5例（5.7％）需要干预，其中2例需要月经抑制，两个需要手术干预，和一个需要进一步成像。
结论：大多数患者完成了推荐的术后PUS筛查。在一小部分患者中，PUS与可疑的Mullerian解剖结构无关，因此需要干预。术后PUS可能是ARM患者识别妇科异常的有用辅助手段。
方法：对所有≥8岁的ARM患者进行了IRB批准的回顾性图表回顾，并记录了该病例。收集有关人口统计学和临床过程的数据。主要结果是坚持推荐的PUS。次要结果包括与疑似Mullerian解剖结构的影像学相关性以及基于影像学发现的干预需求。
结果：总共112例患者符合纳入标准。其中,87（77.7％）完成了推荐的后筛查PUS。根据年龄，完成学业没有差异，种族,与初级保健提供者建立，保险状况,或ARM的类型。9例患者（10.3％）的PUS发现与他们怀疑的苗勒氏解剖结构无关；5例（5.7％）需要干预，其中2例需要月经抑制，两个需要手术干预，和一个需要进一步成像。
结论：大多数患者完成了推荐的术后PUS筛查。在一小部分患者中，PUS与可疑的Mullerian解剖结构无关，因此需要干预。术后PUS可能是ARM患者识别妇科异常的有用辅助手段。
