Post-pubertal gynecologic evaluation and management of patients with anorectal malformations.

The Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) is a group of medical providers dedicated to equitably improving the health and quality of life of individuals affected by congenital colorectal disorders and associated urologic, gynecologic, and other anomalies. Using research and medical expertise, the Gynecology Committee within the PCPLC has developed five consensus statements on gynecologic care of patients born with anorectal malformations: Gynecologic Care in Patients with Anorectal Malformations: a Primer and Call to Action, Methods of Gynecologic Evaluation for Patients with Anorectal Malformations, Prepubertal Gynecologic Evaluation and Management of Patients with Anorectal Malformations, Post-pubertal Gynecology Evaluation and Management of Patients with Anorectal Malformations, Long-term Obstetric and Gynecologic Care for Patients with Anorectal Malformations. In this article, we review pubertal trajectory and necessary evaluation of gynecologic structures throughout puberty, as puberty allows for the development of Müllerian structures and can reveal anomalies that can impact menstrual and reproductive function. Gynecologic management in puberty may require anatomic and anticipatory counseling only: however, for many patients gynecologic management may require suppression of menses or operative intervention, all of which will be discussed in detail in this article.