Adult Obstetricians and Gynecologists Lack Knowledge of Anorectal Malformations-A Call for Action.

OBJECTIVE

Patients with anorectal malformations (ARMs) may have concurrent gynecologic abnormalities. As patients grow, they typically transition from pediatric subspeciality care and seek adult obstetrics and gynecology (OB/GYN)-related services. We aimed to assess adult OB/GYN physicians' knowledge, competency, and comfort regarding meeting the sexual and reproductive health care needs of patients with ARMs.

METHODS

We performed a cross-sectional observational survey-based study of graduates from a single academic OB/GYN residency program from 2013 to 2022. Physicians were surveyed on experience, comfort, and challenges with caring for patients with ARMs and given a knowledge assessment. Descriptive and comparative statistics between those who did and did not complete a Pediatric and Adolescent Gynecology (PAG) rotation were generated.

RESULTS

There were 59 respondents (53.6%). Fewer than half (39.0%) reported caring for a patient with an ARM, an appendicovesicostomy (12.3%), or an appendicostomy (5.4%). Most felt uncomfortable (80.4%) or felt they lacked competence in caring for these patients (81.8%). Most (64.3%) felt that ARMs should be discussed in residency. Only 1 physician (1.7%) answered all questions in the knowledge assessment correctly; 33.9% did not answer any question correctly. On subgroup analysis, more physicians who had completed a pediatric and adolescent gynecology rotation recalled learning about ARMs (83.3% vs 51.9%, P = .03); however, there were no differences in experience, comfort, competence, or willingness to learn.

CONCLUSION

OB/GYN providers report a lack of knowledge and comfort in caring for patients with ARMs. Development of a standardized OB/GYN residency curriculum and education for practicing OB/GYN physicians is necessary to allow access to knowledgeable sexual and reproductive health for this patient population.