Francesca Casalino, Dehlia Moussaoui, Céline Brockmann, Victoria Crofts, Jasmine Abdulcadir, Michal Yaron
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引用次数: 0
Abstract
Study objective: Puberty is associated with important changes in secondary sexual characteristics, but the changes occurring in female external genitalia are not thoroughly described. The aim of this systematic review is to summarize and assess the current scientific knowledge regarding vulvar changes and development during puberty.
Methods: PubMed, Embase, Web of Science, and Cochrane were searched, using keywords related to "puberty", "vulva", and "morphology". Inclusion criteria were observational studies describing vulvar development in individuals between the ages of 8 and 16 years. The outcomes of interest were quantitative and/or qualitative descriptions of the vulva, including anatomical, physiological and histological changes.
Results: Of the 1658 articles screened, 10 were included. The mean clitoral glans diameter increases during puberty, as does the length of the clitoral hood. The clitoral hood changes, to become more retractile and rugose. The inner labia width and length increases throughout puberty, and the development of inner labia varies between individuals, with labial asymmetry being a common characteristic. The most frequent hymenal configuration found during puberty is the crescentic form, and features such as hymenal mounds, longitudinal intravaginal ridges, and most notches, are physiological.
Conclusion: Reliable data on pubertal development of the external female genital organs is scarce. Future research is needed in order to provide more precise data to help categorize vulvar development into stages. A detailed description of vulvar maturation into sequential stages throughout puberty (as done by the Tanner scale for the male homologous structures) can increase knowledge of its morphological diversity and help reach clinical consensus on the nature of pathological variants. In addition, better knowledge of vulvar diversity is of importance to both healthcare professionals and individuals, and may empower and promote self-esteem.
研究目的：青春期与第二性征的重要变化有关，但女性外生殖器发生的变化并没有得到充分的描述。本系统综述的目的是总结和评估目前关于青春期外阴变化和发育的科学知识。方法：检索PubMed、Embase、Web of Science、Cochrane，检索关键词为“青春期”、“外阴”、“形态学”。纳入标准是描述8至16岁个体外阴发育的观察性研究。结果感兴趣的是外阴的定量和/或定性描述，包括解剖，生理和组织学变化。结果：在筛选的1658篇文献中，纳入10篇。阴蒂头的平均直径在青春期增加，阴蒂帽的长度也增加。阴蒂帽变化，变得更加收缩和皱褶。内阴唇的宽度和长度在整个青春期增加，内阴唇的发育因人而异，阴唇不对称是一个共同的特征。在青春期发现的最常见的处女膜形态是新月形，而诸如处女膜丘、纵向阴道内脊和大多数缺口等特征是生理性的。结论：关于女性外生殖器青春期发育的可靠资料很少。未来的研究需要提供更精确的数据来帮助将外阴发育分为不同的阶段。详细描述整个青春期外阴成熟的顺序阶段（如通过Tanner量表对男性同源结构所做的）可以增加对其形态多样性的认识，并有助于就病理变异的本质达成临床共识。此外，更好地了解外阴多样性对医疗保健专业人员和个人都很重要，并可能增强和促进自尊。
期刊介绍：
Journal of Pediatric and Adolescent Gynecology includes all aspects of clinical and basic science research in pediatric and adolescent gynecology. The Journal draws on expertise from a variety of disciplines including pediatrics, obstetrics and gynecology, reproduction and gynecology, reproductive and pediatric endocrinology, genetics, and molecular biology.
The Journal of Pediatric and Adolescent Gynecology features original studies, review articles, book and literature reviews, letters to the editor, and communications in brief. It is an essential resource for the libraries of OB/GYN specialists, as well as pediatricians and primary care physicians.
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