MP53-20 INITIAL UROLOGIC EVALUATION FOR ANORECTAL MALFORMATIONS: A PCPLC RETROSPECTIVE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP53-20 INITIAL UROLOGIC EVALUATION FOR ANORECTAL MALFORMATIONS: A PCPLC RETROSPECTIVE Jennifer Ahn, Caitlin Smith, Samuel Rice-Townsend, Lauren Nicassio, Jeffery Avansino, Megan Durham, Jason Frischer, Casey Calkins, Rebecca Rentea, Matthew Ralls, Megan Fuller, Richard Wood, Michael Rollins, Justin Lee, Ron Reeder, Belinda Dickie, Payam Saadai, Mark Cain, and Paul Merguerian Jennifer AhnJennifer Ahn More articles by this author , Caitlin SmithCaitlin Smith More articles by this author , Samuel Rice-TownsendSamuel Rice-Townsend More articles by this author , Lauren NicassioLauren Nicassio More articles by this author , Jeffery AvansinoJeffery Avansino More articles by this author , Megan DurhamMegan Durham More articles by this author , Jason FrischerJason Frischer More articles by this author , Casey CalkinsCasey Calkins More articles by this author , Rebecca RenteaRebecca Rentea More articles by this author , Matthew RallsMatthew Ralls More articles by this author , Megan FullerMegan Fuller More articles by this author , Richard WoodRichard Wood More articles by this author , Michael RollinsMichael Rollins More articles by this author , Justin LeeJustin Lee More articles by this author , Ron ReederRon Reeder More articles by this author , Belinda DickieBelinda Dickie More articles by this author , Payam SaadaiPayam Saadai More articles by this author , Mark CainMark Cain More articles by this author , and Paul MerguerianPaul Merguerian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003301.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urologic anomalies such as hydronephrosis, solitary kidney, and vesicoureteral reflux are common in individuals with anorectal malformations (ARM). These can lead to renal damage if not detected and managed appropriately. Optimal detection and surveillance strategies have not yet been established. We aim to evaluate current urologic evaluation practices in individuals with anorectal malformation utilizing a multi-center registry. METHODS: We performed a multicenter retrospective study of children with ARM evaluated at sites participating in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC). We included all subjects with ARM who had a colostomy or PSARP within 12 months of birth and were also seen at a PCPLC site within 3 months of birth or ARM diagnosis. The primary outcome was the proportion of subjects undergoing urologic evaluation within 12 months of ARM diagnosis. The secondary outcome was proportion of screened subjects with urologic anomalies. We evaluated associations between urologic evaluation and clinical and sociodemographic characteristics. p-value <0.05 was considered significant. RESULTS: A total of 427 subjects with ARM from 13 institutions were included, and only 22% (93/427) of subjects had a recorded urologic evaluation within 12 months of ARM diagnosis. For imaging studies performed within 12 months of ARM diagnosis, 25% (112/427) underwent renal ultrasound, 8% (34/427) had a voiding cystourethrogram (VCUG), and 1% had a renal scan performed. Kidney anomalies were reported in 58 subjects, with hydronephrosis seen most commonly, followed by horseshoe kidney and ectopic kidney. Vesicoureteral reflux was detected in 20 subjects, comprising 59% of those who had a VCUG performed. On univariate analysis, having a renal ultrasound performed within 12 months of ARM diagnosis was not associated with clinical characteristics, such as ARM complexity or spine/sacrum status. It was associated with Hispanic ethnicity (OR 1.73, CI 1.04, 2.84, p=0.034). CONCLUSIONS: Timely urologic evaluation was recorded only 25% of the time, with a high proportion yielding expected anomalies such as hydronephrosis and vesicoureteral reflux. This suggests many potentially harmful conditions may be going undetected or unrecorded, and routine early evaluation should be standardized. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e720 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jennifer Ahn More articles by this author Caitlin Smith More articles by this author Samuel Rice-Townsend More articles by this author Lauren Nicassio More articles by this author Jeffery Avansino More articles by this author Megan Durham More articles by this author Jason Frischer More articles by this author Casey Calkins More articles by this author Rebecca Rentea More articles by this author Matthew Ralls More articles by this author Megan Fuller More articles by this author Richard Wood More articles by this author Michael Rollins More articles by this author Justin Lee More articles by this author Ron Reeder More articles by this author Belinda Dickie More articles by this author Payam Saadai More articles by this author Mark Cain More articles by this author Paul Merguerian More articles by this author Expand All Advertisement PDF downloadLoading ...