Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a sexual developmental disorder. In this disorder, there is a congenital absence of the uterus and vagina with normal external genitalia. The etiology is not well understood. Variations of this condition exist that may include congenital abnormalities and psychological problems. In this article, we discuss the case of a 47-year-old African American female who presented with acute renal failure, solitary right kidney, and a pelvic mass extending from the pelvis to the right hypochondrium determined to be a fibroid. The patient was managed by a multidisciplinary team, dialyzed, and planned for removal of the mass. While understanding the low probability of having fibroids without a uterus, fibroids should not be excluded from such patients. It is also important to consider the emotional and psychological well-being of such patients.

uremic pruritis (mean 10 cm VAS score .5 cm). Any patients with conditions that could be an alternative cause of pruritis and patients who had pruritis before their kidney failure diagnosis were excluded. The intervention groups received either 100 or 300 mg of oral gabapentin after each dialysis session for 14 days, whereas the control group received placebo. After enrolling five patients in the 300 mg arm, two of them developed excessive somnolence after which the 300 mg arm was discontinued and subsequent patients were randomized to either 100 mg or placebo. Four patients withdrew after randomization but before receiving medication, leaving eight patients in each of the 100 mg and placebo arms and five in the 300 mg arm for final analysis. The primary outcome was percent change in pruritis scores on a 0-cm (no itch) to 10cm (worst imaginable itch) VAS between baseline and day 14. The 100 mg gabapentin regimen reduced VAS scores by 48% versus 11% in placebo (P5.037) from baseline to day 14. The 300 mg gabapentin regimen had an 82% reduction also versus 11% in placebo (P5.0121). As mentioned previously, two patients in the 300 mg group experienced adverse events of lethargy on days 9 and 10, which caused this arm of the study to be terminated early. No other adverse effects were reported.Gabapentin is not approved by the Food and Drug Administration for use in uremic pruritis.