Management Variation in Pediatric Labial Adhesions: A Retrospective Cohort Study

IF 3.9 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2025-03-06 DOI:10.1016/j.jpeds.2025.114529

Riley J. O'Keefe BS, Sarah D. Compton PhD, MPH, Melina L. Dendrinos MD, Monica W. Rosen MD

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引用次数: 0

Abstract

Objective

To compare treatment and outcome differences between primary care providers (PCPs), pediatric and adolescent gynecologists (PAGs), and pediatric urologists (PURs) in management of labial adhesions (LAs).

Study design

This was a retrospective, cohort study of patients aged 0 through 21 presenting for a clinic visit from July 2022 to July 2023 at a single institution, identified by International Classification of Diseases 9th revision/10th revision codes for LA. Management variation was analyzed via cross-tabs with chi-square, Fisher exact test, and two-sample t-tests.

Results

The 159 patients meeting inclusion criteria had a median age of 12 months at diagnosis; 81 were managed by a PCP and 78 were referred to a specialist: 41 (52.6%) PUR, 32 (41.0%) PAG, and 5 (6.4%) other specialists. Forty-one patients presented with urinary issues, with no difference in rate of referral to PUR (37.8%), PAG (15.5%), or continued PCP management (46.7%), P = .17. All patients were initially treated nonsurgically. Surgical intervention rates did not differ between PAG and PUR (P = .21). PUR performed sharp adhesiolysis more often than PAG (P = .011), but there was no difference in blunt adhesiolysis rates between PAG and PUR (P = .17). LA recurred postoperatively in 6 (3.8%) patients.

Conclusions

These results reiterate the efficacy of nonsurgical treatment for most patients with LA and illustrate minor variation in LA management between PAG and PUR.

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.