Abdominopelvic Pain and Overlapping Pain Conditions in Patients With Mayer-Rokitansky-Küster-Hauser Syndrome.

STUDY

OBJECTIVE

Our objectives were to estimate the prevalence of abdominopelvic pain (AP) in patients with Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH), compare the prevalence of AP in patients with anatomic variations and extragenital anomalies in MRKH, and estimate the prevalence of overlapping pain conditions (OPC) in patients with MRKH.

METHODS

Retrospective cohort study of MRKH patients seen at an academic center (2014-2024), identified using ICD-10 codes for uterine agenesis (UA) or vaginal agenesis (VA). Inclusion criteria included a confirmed diagnosis of MRKH. Patients with 46,XY karyotypes were excluded. Descriptive statistics were performed. Chi-square analyses were used for categorical variables and 2-tailed student's t tests were used for continuous variables to compare features of MRKH patients, including presence/absence of uterine remnants (UR). Multivariate logistic regression was performed to further evaluate associations with AP.

RESULTS

A total of 117 patients were identified and subcategorized by UR status (UR n = 63, no UR n = 54), and MRKH type (Type 1 n = 65, Type 2 n = 52). Overall, 36.8% of patients (n = 43) reported persistent AP and 20.5% of patients (n = 24) cyclic AP. UR were associated with persistent (p = .008) and cyclic AP (p = .001). There was no association between MRKH type and persistent (p = .732) or cyclic AP (p = .282). 23.9% of (n = 28) patients were treated for ≥1 OPC, with migraine headache (n = 21) and IBS (n = 8) being most common.

CONCLUSIONS

Given the burden of persistent and cyclic AP among MRKH patients, careful and timely evaluation for pain is warranted. Management should focus on clinical presentation over imaging findings.