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Pediatric Surgery International
Published in: Pediatric Surgery International 1/2023

Open Access 01-12-2023 | Original Article

Potential benefits of routine cystoscopy and vaginoscopy prior to reconstructive surgery in patients with an anorectal malformation

Authors: Cunera M. C. de Beaufort, Daphne T. Boom, Tara M. Mackay, Judith J. M. L. Dekker, Olga E. Arguedas Flores, Justin R. de Jong, Caroline F. Kuijper, Ramon R. Gorter

Published in: Pediatric Surgery International | Issue 1/2023

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Abstract

Purpose

First, to assess the number of patients with anorectal malformations (ARM) in whom additional urological and/or gynecological anomalies were identified through routine screening with cysto- or vaginoscopy prior to reconstructive surgery. Second, to assess potential procedure-related complications.

Methods

Retrospective mono-center cohort study, including all ARM patients born between January 2019 and December 2022. Routine screening consisted of cystoscopy for male patients, with the addition of vaginoscopy for female patients. Chi-square was used to compare the screening percentages over time.

Results

In total, 38 patients were included, of whom 27 (71.1%) underwent cystoscopy ± vaginoscopy, without the occurrence of complications. Nine of 13 females (69.2%) underwent cysto- and vaginoscopy and 18 of 25 males (72.0%) underwent a cystoscopy. The percentage of patients that underwent these procedures improved over the 2 time periods (50.0% in 2019–2020 vs 90.0% in 2021–2022, p = 0.011). In 15 of 27 patients (55.6%) that underwent cystoscopy ± vaginoscopy, additional anomalies were found that were not identified through physical examination or US-kidney.

Conclusions

In 56% of the patients that underwent cysto- ± vaginoscopy, additional anomalies were identified that were not with imaging studies or physical examination. This study emphasizes the potential benefit of routine cysto- and vaginoscopy in the diagnostic work-up of children with ARM.
Level of Evidence: III.
Appendix
Available only for authorised users
Literature
1.
2.
Holschneider A, Hutson J, Peña A, Beket E, Chatterjee S, Coran A et al (2005) Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations. J Pediatr Surg 40(10):1521–1526CrossRefPubMed
3.
Marcelis C, Dworschak G, de Blaauw I, van Rooij I (2021) Genetic counseling and diagnostics in anorectal malformation. Eur J Pediatr Surg 31(6):482–491CrossRefPubMed
4.
de Beaufort CM, van den Akker AC, Kuijper CF, Broers CJ, de Jong JR, de Beer SA, et al. The importance of screening for additional anomalies in patients with anorectal malformations: A retrospective cohort study. Journal of Pediatric Surgery. 2022.
5.
Fuchs ME, Halleran DR, Bourgeois T, Sebastião Y, Weaver L, Farrell N et al (2021) Correlation of anorectal malformation complexity and associated urologic abnormalities. J Pediatr Surg 56(11):1988–1992CrossRefPubMed
6.
Vilanova-Sanchez A, Reck CA, Sebastião YV, Fuchs M, Halleran DR, Weaver L et al (2018) Can sacral development as a marker for caudal regression help identify associated urologic anomalies in patients with anorectal malformation? J Pediatr Surg 53(11):2178–2182CrossRefPubMed
7.
Bjoersum-Meyer T, Kaalby L, Lund L, Christensen P, Jakobsen MS, Baatrup G et al (2021) Long-term Functional Urinary and Sexual outcomes in patients with anorectal malformations-a systematic review. Eur Urol Open Sci 25:29–38CrossRefPubMedPubMedCentral
8.
Goossens WJ, de Blaauw I, Wijnen MH, de Gier RP, Kortmann B, Feitz WF (2011) Urological anomalies in anorectal malformations in The Netherlands: effects of screening all patients on long-term outcome. Pediatr Surg Int 27(10):1091–1097CrossRefPubMedPubMedCentral
9.
Duci M, Midrio P, Castagnetti M, Gamba P, Faggin R, Fascetti-Leon F (2020) Urinary tract anomalies in patients with anorectal malformations: the role of screening and clinical follow-up. Urology 143:216–220CrossRefPubMed
10.
Fanjul M, Lancharro A, Molina E, Cerdá J (2019) Gynecological anomalies in patients with anorectal malformations. Pediatr Surg Int 35(9):967–970CrossRefPubMed
11.
Kruger P, Teague WJ, Khanal R, Hutson JM, King SK (2019) Screening for associated anomalies in anorectal malformations: the need for a standardized approach. ANZ J Surg 89(10):1250–1252CrossRefPubMed
12.
Boemers TM, Beek FJ, Bax NM (1999) Review Guidelines for the urological screening and initial management of lower urinary tract dysfunction in children with anorectal malformations–the ARGUS protocol. BJU Int. 83(6):662–71CrossRefPubMed
13.
Strine AC, VanderBrink BA, Alam Z, Schulte M, Noh PH, DeFoor WR Jr et al (2017) Clinical and urodynamic outcomes in children with anorectal malformation subtype of recto-bladder neck fistula. J Pediatr Urol. 13(4):376.e1-e6CrossRefPubMed
14.
Skerritt C, Vilanova Sánchez A, Lane VA, Wood RJ, Hewitt GD, Breech LL et al (2017) Menstrual, sexual, and obstetrical outcomes after vaginal replacement for vaginal atresia associated with anorectal malformation. Eur J Pediatr Surg 27(6):495–502CrossRefPubMed
15.
Wester T, Tovar JA, Rintala RJ (2012) Vaginal agenesis or distal vaginal atresia associated with anorectal malformations. J Pediatr Surg 47(3):571–576CrossRefPubMed
16.
17.
Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ et al (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Ann Intern Med 147(8):W163–W194CrossRefPubMed
18.
Grimbizis GF, Gordts S, Di Spiezio SA, Brucker S, De Angelis C, Gergolet M et al (2013) The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod 28(8):2032–2044CrossRefPubMedPubMedCentral
19.
Stoll C, Alembik Y, Dott B, Roth MP (2007) Associated malformations in patients with anorectal anomalies. Eur J Med Genet 50(4):281–290CrossRefPubMed
20.
Boemers TM, de Jong TP, van Gool JD, Bax KM (1996) Urologic problems in anorectal malformations. Part 2: functional urologic sequelae. J Pediatr Surg. 31(5):634–7CrossRefPubMed
21.
Rich MA, Brock WA, Peña A (1988) Spectrum of genitourinary malformations in patients with imperforate anus. Pediatr Surg Int 3(2):110–113
22.
23.
Nakhal RS, Wood D, Creighton SM (2012) The role of examination under anesthesia (EUA) and vaginoscopy in pediatric and adolescent gynecology: a retrospective review. J Pediatr Adolesc Gynecol 25(1):64–66CrossRefPubMed
24.
Liu Y, Fan D, Fu Y, Wu S, Wang W, Ye S et al (2018) Diagnostic accuracy of cystoscopy and ultrasonography in the prenatal diagnosis of abnormally invasive placenta. Medicine (Baltimore) 97(15):e0438CrossRefPubMed
25.
Bar-Yosef Y, Binyamini J, Sofer M, Ben-Chaim J (2016) Role of routine cystoscopy and cystography in exstrophy-epispadias complex. J Pediatr Urol 12(2):117.e1–4CrossRefPubMed
26.
27.
Hirdes MM, de Jong TP, Dik P, Vijverberg MA, Chrzan R, Klijn AJ (2010) Urethral length in girls with lower urinary tract symptoms and forme fruste of female epispadias. J Pediatr Urol 6(4):372–375CrossRefPubMed
28.
Halleran DR, Thompson B, Fuchs M, Vilanova-Sanchez A, Rentea RM, Bates DG et al (2019) Urethral length in female infants and its relevance in the repair of cloaca. J Pediatr Surg 54(2):303–306CrossRefPubMed
Metadata
Title
Potential benefits of routine cystoscopy and vaginoscopy prior to reconstructive surgery in patients with an anorectal malformation
Authors
Cunera M. C. de Beaufort
Daphne T. Boom
Tara M. Mackay
Judith J. M. L. Dekker
Olga E. Arguedas Flores
Justin R. de Jong
Caroline F. Kuijper
Ramon R. Gorter
Publication date
01-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-023-05565-0

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