SIZE OF PELVIC BONY OUTLET IN RENAL AGENESIS

¹ Fellow in Pediatric Radiology, Babies Hospital, Columbia-Presbyterian Medical Center, Maternal Child Health Division, Department of Health, Education and Welfare, Grant No. 153.

A small bony pelvic outlet had previously been noted in newborns with lethal respiratory problems who had absent or nonfunctioning kidneys and bladder hypoplasia. The suggestion was made that the small pelvic bony outlet reflected the bladder development, and that these roentgenographic findings were a clue to renal agenesis in newborns with respiratory distress. All the patients also had imperforate anus with rectovesical fistula and segmental sacral agenesis.

Three patients are reported, all of whom had small bladders. In 2 there were renal agenesis and bladder hypoplasia, but the bony pelvis was normal. In the third case, bladder hypoplasia and a small pelvic outlet were present; the patient had segmental sacral agenesis with normal kidneys and has survived.

Review of all prior cases of small bony pelvic outlet reveals the common denominator to be neuromuscular deficit accompanying segmental sacral agenesis rather than renal agenesis or bladder hypoplasia, When imperforate anus with sacral and urologic anomalies are present, the patients illustrate the syndrome of "caudal regression." Renal agenesis as an isolated anomaly is not associated with sacral or pelvic outlet abnormalities; bladder size per se plays no role in the appearance of the pelvic bones.

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