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

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Potential benefits of routine cystoscopy and vaginoscopy prior to reconstructive surgery in patients with an anorectal malformation
Pediatric Surgery International ( IF 1.5 ) Pub Date : 2023-10-27 , DOI: 10.1007/s00383-023-05565-0
Cunera M C de Beaufort _{1,

2,

3} , Daphne T Boom ₄ , Tara M Mackay ₅ , Judith J M L Dekker ₆ , Olga E Arguedas Flores ₄ , Justin R de Jong _{1,

2,

3} , Caroline F Kuijper ₄ , Ramon R Gorter _{1,

2,

3}

Affiliation

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.

中文翻译：

肛门直肠畸形患者重建手术前常规膀胱镜检查和阴道镜检查的潜在益处

目的

首先，评估在重建手术前通过膀胱镜或阴道镜常规筛查发现其他泌尿科和/或妇科异常的肛门直肠畸形 (ARM) 患者的数量。其次，评估潜在的手术相关并发症。

方法

回顾性单中心队列研究，包括 2019 年 1 月至 2022 年 12 月出生的所有 ARM 患者。常规筛查包括男性患者的膀胱镜检查，以及女性患者的阴道镜检查。卡方用于比较随时间变化的筛选百分比。

结果

共纳入38例患者，其中27例（71.1%）接受膀胱镜±阴道镜检查，未出现并发症。 13 名女性中的 9 名 (69.2%) 接受了膀胱镜检查和阴道镜检查，25 名男性中的 18 名 (72.0%) 接受了膀胱镜检查。接受这些手术的患者百分比在这两个时期内有所改善（2019-2020 年为 50.0%，2021-2022 年为 90.0%，p = 0.011）。在接受膀胱镜检查±阴道镜检查的 27 名患者中，有 15 名 (55.6%) 发现了通过体检或超声肾脏未发现的其他异常情况。