ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO619

Are Patients With Renal Anomalies at Risk for Müllerian Anomalies?

Session Information

  • Pediatric Nephrology - II
    November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1800 Pediatric Nephrology

Authors

  • Walawender, Laura E., Nationwide Children's Hospital, Columbus, Ohio, United States
  • Fei, Yueyang Frances, Nationwide Children's Hospital, Columbus, Ohio, United States
  • Becknell, Brian, Nationwide Children's Hospital, Columbus, Ohio, United States
  • Mcleod, Daryl J., Nationwide Children's Hospital, Columbus, Ohio, United States
Background

Patients with Müllerian anomalies have a 30-50% increased prevalence of congenital renal anomalies, but the prevalence of Müllerian anomalies among patients with known congenital renal anomalies is unknown. A delay in diagnosis of obstructive Müllerian anomalies can increase the risk of poor clinical outcomes including pelvic inflammatory disease, abscess, infertility, and endometriosis. The goal of this study was to describe the prevalence of Müllerian anomalies in a cohort of patients with known congenital renal anomalies.

Methods

A retrospective electronic medical record review was performed of patients within the Nationwide Children’s Hospital system with ICD9 or ICD10 diagnostic codes for both urologic and gynecologic anomalies. Patients with complex urogenital pathology, such as, cloaca, urogenital sinus, or bladder exstrophy were excluded. Renal anomaly diagnosis, Müllerian anomaly diagnosis, reason for pelvic evaluation, type of evaluation, and age of diagnosis of both renal and Müllerian anomalies were evaluated.

Results

136 patients were identified as having both urologic and gynecologic codes; 80 were excluded based on the exclusion criteria. Of the 56 eligible patients, 31 (55%) had a congenital solitary kidney. The type of and reason for pelvic evaluation was determined for 46 patients. Abdominal pain/dysmenorrhea was the most common reason for pelvic evaluation (38%), most often by ultrasound (70%), leading to the diagnosis of a Müllerian anomaly in 41 (73%) patients. Among the 38 patients with renal and Müllerian anomalies, 24 (63%) had an initial diagnosis of a renal anomaly; 6 (16%) had an initial diagnosis of Müllerian anomaly, and 8 (21%) were diagnosed with both simultaneously. 16 patients (39%) had a Müllerian obstruction, and 9 underwent urgent surgical intervention within 2 weeks of the diagnosis.

Conclusion

In this study, over half of the patients had a renal anomaly diagnosed before their Müllerian anomaly, which was obstructive in over one-third of instances. Given the primacy of early diagnosis for obstructive Müllerian anomalies, there is a need for a prospective study in patients with congenital renal anomalies to determine if routine pelvic ultrasound at thelarche or around the age of expected menarche could reduce the rate of obstructive Müllerian anomalies presenting acutely.