Saline Test Predicts Menstrual Health in Cloacal Patients
Research By: Taryn Wassmer, MD | Lesley Breech, MD
Post Date: May 2, 2025 | Publish Date: May 2025
Pediatric and Adolescent Gynecology | Top Scientific Achievement
Saline pertubation (SP) is emerging as a reliable new method to assess menstrual patency in young girls with cloacal anomaly—a rare and complex congenital condition affecting the urinary, rectal, and reproductive tracts.
A study evaluating the method, led by Taryn Wassmer, MD, and colleagues in the Division of Pediatric and Adolescent Gynecology at Cincinnati Children’s, was published in May 2025 in the Journal of Pediatric Surgery.
The simple, low-cost intraoperative test uses sterile saline to assess whether the Müllerian system—the uterus, cervix, and upper vagina—will allow menstrual flow at puberty. Among 52 patients who underwent SP, the test demonstrated 95.9% sensitivity for predicting menstrual patency, helping identify those at low risk of future obstruction.
“Menstrual obstruction can lead to chronic pain, endometriosis, and even infertility,” says Lesley Breech, MD, senior co-author and director, Division of Pediatric and Adolescent Gynecology. “Having a safe, effective way to evaluate these patients before puberty allows us to tailor follow-up care and prevent serious complications later on.”
SP was also found to be safe, with minimal long-term risk to the fallopian tubes. Compared to patients who did not undergo SP, those who received the test had lower rates of hydrosalpinx (fluid-filled fallopian tubes) and tuboovarian abscess. The authors emphasize that SP should be performed by experienced pediatric surgical teams during procedures already planned for other reasons. Doing so reduces surgical risk while providing valuable insights into reproduction.
The team next plans to refine follow-up protocols based on SP results and explore how this approach may inform fertility counseling for patients as they reach adolescence and young adulthood.
About the study
Cincinnati Children’s co-authors also included Viktoriya Tulchinskaya, MD; Aimee Morrison, MD; and Jason Frischer, MD.
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| Original title: | Assessment of Müllerian Patency in Patients With Cloacal Anomaly Using Saline Pertubation: A Retrospective Cohort Study |
| Published in: | Journal of Pediatric Surgery |
| Publish date: | May 2025 |
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