V03-07 THE USE OF INTRAOPERATIVE MRI (IMRI) AT THE TIME OF CYSTOVAGINOSCOPY FOR PATIENT WITH CLOACAL ANOMALY

Abstract

You have accessJournal of UrologyPediatrics (V03)1 Sep 2021V03-07 THE USE OF INTRAOPERATIVE MRI (IMRI) AT THE TIME OF CYSTOVAGINOSCOPY FOR PATIENT WITH CLOACAL ANOMALY Poone Shoureshi, Christopher Austin, and Casey Seideman Poone ShoureshiPoone Shoureshi More articles by this author , Christopher AustinChristopher Austin More articles by this author , and Casey SeidemanCasey Seideman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001991.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients born with cloacal anomalies pose a significant reconstructive challenge to pediatric urologists. Preoperative workup with endoscopy and imaging to assess the length of the confluence is vital to determining the proper surgical approach for treatment. MRI is increasingly being used to assess anorectal malformations as it provides a clear image without radiation exposure. We present a unique case of an exam under anesthesia with simultaneous multiparametric intraoperative MRI (iMRI) for preoperative assessment of cloacal anomaly. METHODS: Our patient is a 7-month-old female with cloacal anomaly, bilateral ectopic ureters, grade 5 vesicoureteral reflux bilaterally, caudal dysgenesis, left lower extremity abnormalities, and imperforate anus s/p colostomy. She was scheduled for cystoscopy, vaginoscopy and exam under anesthesia for preoperative evaluate. We elected to perform simultaneous, intraoperative pelvic and abdominal MRI to avoid multiple sedation procedures. RESULTS: Cystovaginoscopy demonstrated a normal appearing bladder, an incompetent bladder neck, bilateral ectopic ureters entering just distal to bladder neck, and two vaginal openings. Prior to performing the iMRI, a Foley catheter was placed in the right hemivagina, the bladder, and a pollack catheter in the left hemivagina. We instilled a total of 10cc gadolinium and performed the iMRI. The common channel measured 3.3 cm and the urethra 1.3 cm. CONCLUSIONS: The novel use of iMRI simultaneously with cystovaginoscopy can further enhance the preoperative workup in patients with complex anomalies such as cloacal malformation, and avoids multiple sedation procedures. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e224-e224 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Poone Shoureshi More articles by this author Christopher Austin More articles by this author Casey Seideman More articles by this author Expand All Advertisement Loading ...