Srinivas Shruthi, Wilson Jenna, Bergus Katherine C, Kebodeaux Chelsea, McCracken Kate, Wood Richard J, Hewitt Geri
Department of Colorectal and Pelvic Reconstruction Surgery, Nationwide Children's Hospital, Columbus, Ohio.
The Ohio State University College of Medicine, Columbus, Ohio.
J Pediatr Adolesc Gynecol. 2025 Feb;38(1):68-74. doi: 10.1016/j.jpag.2024.09.001. Epub 2024 Sep 17.
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.
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.
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.
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.
肛门直肠畸形（ARM）患者可能同时存在妇科异常。随着患者成长，他们通常会从儿科专科护理过渡到寻求成人妇产科（OB/GYN）相关服务。我们旨在评估成人妇产科医生在满足ARM患者性健康和生殖健康护理需求方面的知识、能力和舒适度。
我们对2013年至2022年来自单一学术性妇产科住院医师培训项目的毕业生进行了一项基于横断面观察性调查的研究。对医生就照顾ARM患者的经验、舒适度和挑战进行了调查，并进行了知识评估。对完成和未完成儿科与青少年妇科（PAG）轮转的医生进行了描述性和比较性统计。
有59名受访者（53.6%）。不到一半（39.0%）的人报告曾照顾过ARM患者、阑尾膀胱造口术患者（12.3%）或阑尾造口术患者（5.4%）。大多数人（80.4%）感到不舒服，或者觉得自己在照顾这些患者方面缺乏能力（81.8%）。大多数人（64.3%）认为在住院医师培训期间应该讨论ARM。在知识评估中，只有1名医生（1.7%）全部回答正确；33.9%的人没有任何一题回答正确。在亚组分析中，完成儿科与青少年妇科轮转的医生中，更多人回忆起学过ARM相关知识（83.3%对51.9%，P = 0.03）；然而，在经验、舒适度、能力或学习意愿方面没有差异。
妇产科医疗服务提供者报告称，在照顾ARM患者方面缺乏知识和舒适度。有必要为妇产科住院医师制定标准化课程，并对执业妇产科医生进行教育，以便为这一患者群体提供有知识的性健康和生殖健康服务。
