Chairs: Stephanie M. Cizek, Krista Childress

Faculty: Stephanie M. Cizek, Krista Childress, Lissa X. Yu, Allison Mayhew

Description: This course provides a comprehensive review of anatomic differences and surgical histories in childhood that may impact future care by the gynecologic surgeon. This course will review A) complex congenital anatomy affecting the pelvis such as anorectal malformations/exstrophy, renal anomalies, Mullerian anomalies, or intersex/Difference of Sex Development (DSD) conditions, and B) the childhood surgeries to address these conditions which the adult gynecologic surgeon may later encounter, such as vaginoplasty/genitoplasty procedures and bowel/bladder conduits. We will use case-based discussion to review relevance of these findings to menstruation, pelvic pain, penetrative vaginal intercourse, and pregnancy/obstetrical outcomes likely to be encountered by adult gynecologic surgeons and provide a toolkit for clinical questions and surgical planning when managing patients with complex pelvic medical and surgical histories.

Learning Objectives: At the end of this course, the participant will be able to:

1. Objective Evaluate a patient's pediatric medical and surgical history and identify red flags that will impact adult gynecologic surgical management;
2. Objective Identify key questions necessary to assess a patient's history regarding voiding, stooling, and previous surgery to identify what partnership may be needed in the comprehensive care of these patients; and
3. Objective Choose the appropriate individualized patient counseling and surgical management for these various congenital conditions.

Course Outline

9:15 AM Welcome, Introduction and Course Overview

S. Cizek

9:20 AM Bladder Concerns and Surgical Implications: Congenital Differences e.g. Bladder Exstrophy, Surgical Treatments e.g. Mitrofanoff, Neovagina (graft/nongraft)/Genital Surgery

S. Cizek

9:45 AM Pediatric Congenital Anorectal/Urogenital Anomaly Anatomy Review and Associated Mullerian Anomalies

K. Childress

10:10 AM Bowel Management and the Anorectal Malformation Patient: Early Interventions Such As Psarp, Later Care e.g. Bowel Conduits and Vaginal/Genitoplasty Revisions

L. Yu

10:35 AM Other Pediatric Surgical Considerations: NEC, hx VP Shunt, Kidney Transplant, Horseshoe Kidney, Extra Ureter

A. Mayhew

11:00 AM Discussion Questions & Answers

9:15 AM Adjourn