Journal of Pediatric and Adolescent Gynecology

STUDY OBJECTIVE: Lower urinary tract symptoms (LUTS) can have a pronounced impact on adolescent women's overall health and quality of life, both during adolescence and across the life course. Little research has examined adolescent women's knowledge, attitudes, and beliefs about bladder health and preventing LUTS. METHODS: This study combines data from two large multi-site focus group studies of individuals born female who identified as women conducted by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium...

BACKGROUND: Mullerian adenosarcoma of the cervix is a rare biphasic tumor composed of a benign epithelial component and a malignant stromal component. Here, we report a rare case of Mullerian adenosarcoma of the cervix in an adolescent girl treated with hysteroscopic resection. CASE PRESENTATION: A 16-year-old girl presented to the Affiliated Hospital of North Sichuan Medical College in April 2017 with a one-year history of a painless vaginal mass. 10 hours prior to presentation, she had experienced rapid enlargement of the vaginal mass and mild vaginal bleeding...

STUDY OBJECTIVE: Evidence-based menstrual health education is not mandated in any U.S. state or territory. Aspects of normal and abnormal menstruation impact quality of life and educational engagement, but many youth are not prepared to know when to seek medical help. We sought to determine which topics should be included in a 3rd through 8th grade school-based menstrual health curriculum. METHODS: We conducted a cross-sectional online survey of medical professionals who care for patients with menstrual problems...

OBJECTIVE: Patients with anorectal malformations (ARMs) may have concurrent gynecologic abnormalities. As patients grow, they typically transition from pediatric subspeciality care and seek adult OB/GYN related services. We aimed to assess adult OB/GYN physicians' knowledge, competency, and comfort meeting the sexual and reproductive health care needs of patients with ARM. METHODS: We performed a cross-sectional observational survey-based study of graduates from a single academic OB/GYN residency program from 2013-2022...

STUDY OBJECTIVE: In an increasing number of states, parents must provide permission for their daughters under 18-years-old to start contraception. We sought to understand perceptions among mother-daughter dyads about sources of information, and to describe dyadic interactions when discussing contraception. METHODS: Dyads were recruited from an adolescent medicine clinic in Dallas, TX. A semi-structured joint interview was conducted with each dyad. Interviews were recorded, transcribed, and coded through an iterative approach...

Today it is globally recognized that sexual and reproductive health is a human rights issue critical to economic growth and stability, ending poverty, and fostering sustainable development. Calls for improving sexual and reproductive health, including a spotlight on adolescents and young women, are highlighted in the Sustainable Development Goals (SDGs) adopted by the United Nations in 2015. In this commentary, we aim to (1) briefly review the history and objectives of global development goals (2) review the adolescent health related SDG targets and indicators with focus on sexual and reproductive health (3) discuss global progress and challenges in achieving target measures and (4) examine action steps that clinicians can take to accelerate progress...

BACKGROUND: Patients with intellectual and developmental disabilities (IDD) experience greater unmet medical service needs and decreased care satisfaction compared to those without these diagnoses. There are no evidence-based resources widely available to prepare children with IDD for menarche. METHODS: This IRB approved embedded mixed methods study investigated the efficacy of "period kits" for patients with IDD to ease anxiety and improve preparedness for menarche...

This advocacy statement endeavors to clarify the concept of the hymen as a symbol of "virginity". The anatomic variants of this structure precludes any correlation to prior sexual activity and the value of physical assessment of this structure is thus questioned. Moreover, physical examination of the hymen is painful, traumatic and humiliating and is a form of gender-based violence. This statement exhorts various sectors-governments, educators, the medical community and the general public-to discard the concept of the "virgin hymen", avoid its use when documenting sexual abuse, and provide progressive education to affirm female sexuality...

BACKGROUND: Childhood cancer treatment can lead to subfertility in adulthood. Fertility tissue preservation offers a way to safeguard future fertility, especially for prepubescent children, whose preservation options are limited. While this is a significant technological advance, it also presents unique challenges compared to other methods of fertility preservation. Clinical consensus is that all childhood cancer patients should receive high-quality, personalised survivorship care and that healthcare policy and practice must address the expectations and priorities of care recipients...

The objective of this document is to provide guidance on the recognition, diagnosis and management of non-sexually acquired genital ulcers in the pediatric and adolescent patient. Commonly known as genital or vulvar aphthous ulcers, lesions are typically seen in the peri-menarchal population, are exquisitely painful, generally self-limited and managed with supportive care. Details of ulcer physical appearance, proposed etiology and options for management are provided to familiarize clinicians with this entity, which can be alarming for patients and families...

STUDY OBJECTIVE: To explore the use of exam under anesthesia with vaginoscopy (EUA-V) following vaginoplasty in patients with congenital adrenal hyperplasia (CAH). DESIGN: Retrospective cohort METHODS: An IRB-approved retrospective chart review was performed of the post-surgical follow-up care of all patients diagnosed with classical CAH who sought care at a tertiary children's hospital from 2000-2017 and had undergone vaginoplasty at that institution. RESULTS: Twenty-six patients met inclusion criteria...

BACKGROUND: The septate uterus is the most common uterine abnormality, comprising 35% of all identified uterine malformations. According to the ESHRE/ESGE 2013 classification, the class U2bC2V1 is a rare congenital malformation characterized by a complete septate uterus with double cervix and nonobstructive longitudinal vaginal septum. STUDY OBJECTIVE: to share the decision-making process, the preoperative ultrasonographic assessment and our step-by-step hysteroscopic surgery technique to manage this complex malformation: including how to access the septate uterine cavity, the resection of the septum and its post-operative management...

STUDY OBJECTIVE: To assess the knowledge of ovulation and menstruation of adolescent females in Western Australia. METHODS: A validated adolescent ovulatory menstrual health literacy questionnaire was used in a cross-sectional study, which included an open-response question inviting participants' reflections. RESULTS: Participants (n=297) were from two single sex and seven co-educational schools of varied socio-educational advantage. Mean chronological age was 15 years and mean gynaecological age was two years...

STUDY OBJECTIVE: Cyberchondria is defined as a form of anxiety characterized by excessive health searches on the Internet. Our aim in this study is to investigate the extent of cyberchondria in adolescents with polycystic ovary syndrome and to compare them with adolescents of the same age. METHODS: 426 adolescents who presented to clinic between April 2023 and September 2023 and agreed to participate in the study were included in the study. Patients were divided into two groups: polycystic ovary syndrome (PCOS) group (135 patients) and control group (291 patients)...

STUDY OBJECTIVE: Premenstrual syndrome (PMS), dysmenorrhea, and abnormal uterine bleeding are frequent gynecological problems in adolescent girls. Studies show that sleep disorders and menstrual cycle irregularities are common conditions and indicate that they may occur together. Studies on the relationship between sleep quality and menstruation are mostly available for late adolescents (17 years and older) and young adult age groups. Our study aims to evaluate this relationship in adolescents aged 12-18...

PURPOSE: As part of a larger study about pregnancy options counseling with adolescents, we interviewed women in the U.S. who chose abortion during adolescence about preferences and experiences regarding communication from healthcare professionals during abortion care. METHODS: We conducted individual semi-structured interviews with women ages 18-35 years old who were pregnant before age 20 years old and chose abortion. We recruited participants through social media, a research registry, and flyers in healthcare facilities...

Despite a national decline in teenage pregnancy rates, Latinxs and Black individuals continue to have higher teenage birth rates compared to white teens. In the United States, Latinx females (ages 15-19) are more than twice as likely to have a teenage birth compared to non-Latinx white teens. With an increasingly diverse nation, a shift towards culturally inclusive approaches to care is critical to achieving equitable patient outcomes. Improving access to preventative care, workforce diversity, and insurance coverage will lead to cost-savings and also help restore trust in a system that has failed past generations...

Clostridium perfringens is responsible for 5% of septic abortions. Emergent hysterectomy is often required for patient survival. This can be devastating to patients desiring future fertility. We report a 15-year-old female patient at 17-week 6 day gestation with diagnosis of sepsis on admission. She was managed with broad spectrum antibiotics followed by immediate evacuation of the retained placenta. Blood and placental cultures confirmed Clostridial species. Successful conservative management allowed for a term pregnancy two years later resulting in a healthy newborn...

STUDY OBJECTIVE: To evaluate the relationship between polycystic ovary syndrome (PCOS), night eating syndrome (NES), and sleep problems in the adolescent population. METHODS: PCOS patients (n = 43) and healthy controls (n = 62) aged between 15 and 19 years were recruited from the clinics of Adolescent Medicine and Adolescent Gynecology. The Night Eating Questionnaire (NEQ), Pittsburg Sleep Quality Index (PSQI), and Pediatric Sleep Questionnaire-short form (PSQ-SF) were completed by the participants...

PURPOSE: To assess young people's interest in advance provision (AP) of medication abortion- receiving mifepristone and misoprostol from a clinician in advance for their future use. METHODS: From November 2022-August 2023 we administered an electronic survey regarding advance provision to patients assigned female at birth at four Bay Area youth-serving clinics. RESULTS: Among 152 people ages 14-24 years (mean 17.9) surveyed, 73.7% (95% CI, 65...