title: Mayer-Rokitansky-Küester-Hauser (MRKH) syndrome with rectovestibular fistula and imperforate anus.
abstract: OBJECTIVE
  The Mayer-Rokitansky-Küester-Hauser (MRKH) syndrome can be either isolated uterovaginal agenesis or associated with other organ anomalies. However, MRKH co-existing with rectovestibular fistula and imperforate anus is uncommonly seen. We present the specific clinical manifestation and discuss the diagnosis and treatment for this unique subtype of MRKH.
  
  
  METHODS
  We reviewed 133 cases with MRKH admitted in our hospital within a 10-year span. Among them, three cases of uterovaginal agenesis concomitant with rectovestibular fistula and imperforate anus were reported in detail.
  
  
  RESULTS
  This scenario of MRKH with rectovestibular fistula was characterized by the common features of two openings in the perineum along with an imperforate anus. Our patients were older girls whose main complaints were of primary anomerrhea and leakage of loose stool. A one-stage repair of anorectovaginoplasty was used in two patients, and with laparoscopic assistance in one case. Thirty-two similar cases in the previous relevant literature were also systematically reviewed.
  
  
  CONCLUSIONS
  MRKH with rectovestibular fistula and imperforate anus is extremely rare. A thorough understanding of this unique entity helps establish the correct and timely diagnosis, and also avoids inappropriate operative treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, PR China.
authors.forename: Shu
authors.initials: S
authors.lastname: Wang
authors.forename: Jing He
authors.initials: JH
authors.lastname: Lang
authors.forename: Lan
authors.initials: L
authors.lastname: Zhu
mesh_terms: D000015:Abnormalities, Multiple / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D001006:Anus, Imperforate / Q000601:surgery*; D005260:Female; D006801:Humans; D012006:Rectovaginal Fistula / Q000601:surgery*; D014599:Uterus / Q000002:abnormalities*; D014621:Vagina / Q000002:abnormalities*; D055815:Young Adult