title: Uterine remnants and pelvic pain in females with Mayer-Rokitansky-Küster-Hauser syndrome.
abstract: OBJECTIVE
  To assess the association between pelvic pain and uterine remnants and review the management of pelvic pain in females with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Department of Obstetrics and Gynecology at a tertiary referring medical center.
  
  
  METHODS
  Forty-eight females with MRKH presenting from 1997 to 2011 with anatomy confirmed by magnetic resonance imaging (MRI).
  
  
  METHODS
  None.
  
  
  METHODS
  Prevalence Of uterine remnants and the association of uterine remnants with pelvic pain in females with MRKH.
  
  
  RESULTS
  Of the 48 females with MRKH, 23 (48%) had uterine remnants and 22 (46%) had pelvic pain. Presence of endometrium was associated with pelvic pain (RR = 2.3; 95% CI = 1.2-4.7) in females with MRKH. Of the females with MKRH and pain, 9/22 had laparoscopy, with endometriosis seen in 5/9 of the uterine remnants at stages higher than are usually seen in teenagers (56%). Nine patients with pain and uterine remnants (8 with endometrium, 1 without) had laparoscopic removal of uterine remnants with resolution of pain.
  
  
  CONCLUSIONS
  Given the high prevalence of uterine remnants in females with MRKH, anatomic evaluation with MRI should be considered when assessing the etiology of pelvic pain. Presence of endometrium within uterine remnants, and subsequent endometriosis, in females with MRKH may be associated with pelvic pain necessitating surgical or medical management.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan 48109-0276, USA. rowlandc@med.umich.edu
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Marsh
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Will
authors.forename: Noam
authors.initials: N
authors.lastname: Smorgick
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Quint
authors.forename: Hero
authors.initials: H
authors.lastname: Hussain
authors.forename: Yolanda R
authors.initials: YR
authors.lastname: Smith
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000150:complications* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D000013:Congenital Abnormalities / Q000601:surgery; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use; D004715:Endometriosis / Q000150:complications* / Q000601:surgery; D004717:Endometrium / Q000002:abnormalities / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000601:surgery; D017699:Pelvic Pain / Q000209:etiology* / Q000628:therapy*; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000150:complications* / Q000601:surgery; D014599:Uterus / Q000002:abnormalities* / Q000601:surgery; D055815:Young Adult
chemical_list: D000700:Analgesics; D003277:Contraceptives, Oral, Combined