Journal of pediatric and adolescent gynecology最新文献

{"title":"Menstrual Health Education: School Health Curriculum Topics by Grade Level Recommended by Specialized Medical Professionals in Menstrual Health Clinics","authors":"Sydney C. Jones MD,&nbsp;Maureen K. Baldwin MD, MPH","doi":"10.1016/j.jpag.2024.09.003","DOIUrl":"10.1016/j.jpag.2024.09.003","url":null,"abstract":"<div><h3>Study Objective</h3><div>Evidence-based menstrual health education is not mandated in any US state or territory. Aspects of normal and abnormal menstruation impact quality of life and educational engagement, but many youths are not prepared to know when to seek medical help. We sought to determine which topics should be included in a third- through eighth-grade school-based menstrual health curriculum.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional online survey of medical professionals who care for patients with menstrual problems. We asked participants to indicate the top 3 menstrual health topics by grade, and we compared the most common responses by year. We also solicited general comments about the curriculum content.</div></div><div><h3>Results</h3><div>Surveys from 55 medical professionals met the criteria for analysis. The topics selected most frequently were normal and abnormal menstruation, reproductive anatomy, puberty timeline, and menstrual products. Most recommended the topics of puberty timeline (38, 69.1%) and reproductive anatomy (34, 61.8%) for third grade, introducing normal menstruation (31, 56.4%) and menstrual products (24, 46.3%) in fourth grade, and abnormal menstruation (27, 49.1%) in sixth grade. More complex topics, such as world cultures around menstruation (14, 25.5%) and period poverty (11, 20.0%), were preferred for eighth grade. Many providers emphasized the importance of teaching normal vs abnormal menstruation in a school health curriculum.</div></div><div><h3>Conclusion</h3><div>Medical professionals provided recommendations for a school-based menstrual health curriculum that introduces topics at developmentally appropriate ages from a medical perspective, teaches basic menstrual symptom management, and instructs on warning signs for abnormal menstruation.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 39-44"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neovaginoplasty With Nile Tilapia Skin Graft in A Patient With Gonadal Dysgenesis: A Case Report","authors":"Samuel Soares Coutinho BM ,&nbsp;Luana Darc de Menezes Braga BM ,&nbsp;Mylena Evilyn Sousa Costa BM ,&nbsp;Mariana Oliveira Veloso BM ,&nbsp;Ana Paula Negreiros Nunes Alves PhD ,&nbsp;Edmar Maciel Lima Júnior MSc ,&nbsp;Zenilda Vieira Bruno PhD ,&nbsp;Manoel Odorico de Moraes Filho PhD ,&nbsp;Carlos Roberto Koscky Paier PhD ,&nbsp;Felipe Augusto Rocha Rodrigues PhD ,&nbsp;Leonardo Robson Pinheiro Sobreira Bezerra PhD","doi":"10.1016/j.jpag.2024.07.008","DOIUrl":"10.1016/j.jpag.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Gonadal dysgenesis, a genetic condition characterized by incomplete of defective formation of the gonads, can present with vaginal agenesis in individuals with 46, XY karyotype.</div></div><div><h3>Case</h3><div>We report an innovative intervention in the management of vaginal agenesis in a 19-year-old female with gonadal dysgenesis. Despite initial attempts with vaginal dilators, the patient presented unresponsive, leading to the adoption of a neovaginoplasty using Nile Tilapia Fish Skin (NTFS) as graft. The procedure, based on the McIndoe technique, involved the creation of a 10 cm x 3 cm vaginal canal with an NTFS-wrapped acrylic mold without complications.</div></div><div><h3>Conclusion</h3><div>The use of NTFS as a graft for neovaginoplasty in gonadal dysgenesis, a novel approach not previously reported in medical literature for this diagnosis, demonstrated favorable outcomes in terms of functionality and patient well-being.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 93-97"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative and Operative Considerations for Minimally Invasive Surgery in Pediatric and Adolescent Gynecology","authors":"Heather Appelbaum MD, FACOG","doi":"10.1016/j.jpag.2024.07.006","DOIUrl":"10.1016/j.jpag.2024.07.006","url":null,"abstract":"<div><div>Minimally invasive surgery (MIS) techniques, including vaginoscopy, laparoscopy, and robotic-assisted surgery, have revolutionized the field of gynecology, offering numerous benefits, such as reduced postoperative pain, shorter hospital stays, and faster recovery. Although these techniques are widely employed in adult gynecologic surgery, their application in pediatric and adolescent patients requires careful consideration due to anatomic differences, patient size, and specific surgical requirements in children. Various aspects of MIS in pediatric and adolescent gynecology, including patient positioning, laparoscopic and robotic instrument choices, trocar placement, surgical techniques, and perioperative pediatric adaptations to MIS, are discussed. The findings highlight the unique challenges and opportunities in performing MIS for pediatric and adolescent patients undergoing gynecologic surgery, emphasizing the need for specialized training and multidisciplinary collaboration.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 18-25"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myth Busting: Virginity and the Hymen","authors":"Paula J Adams Hillard MD (JPAG Editor-in-ChiefShe, her, hers)","doi":"10.1016/j.jpag.2025.01.012","DOIUrl":"10.1016/j.jpag.2025.01.012","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 2-3"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Obstetricians and Gynecologists Lack Knowledge of Anorectal Malformations—A Call for Action","authors":"Shruthi Srinivas MD, MPH ,&nbsp;Jenna Wilson BS ,&nbsp;Katherine C. Bergus MD, MPH ,&nbsp;Chelsea Kebodeaux MD ,&nbsp;Kate McCracken MD ,&nbsp;Richard J. Wood MD ,&nbsp;Geri Hewitt MD","doi":"10.1016/j.jpag.2024.09.001","DOIUrl":"10.1016/j.jpag.2024.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with anorectal malformations (ARMs) may have concurrent gynecologic abnormalities. As patients grow, they typically transition from pediatric subspeciality care and seek adult obstetrics and gynecology (OB/GYN)-related services. We aimed to assess adult OB/GYN physicians’ knowledge, competency, and comfort regarding meeting the sexual and reproductive health care needs of patients with ARMs.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional observational survey-based study of graduates from a single academic OB/GYN residency program from 2013 to 2022. Physicians were surveyed on experience, comfort, and challenges with caring for patients with ARMs and given a knowledge assessment. Descriptive and comparative statistics between those who did and did not complete a Pediatric and Adolescent Gynecology (PAG) rotation were generated.</div></div><div><h3>Results</h3><div>There were 59 respondents (53.6%). Fewer than half (39.0%) reported caring for a patient with an ARM, an appendicovesicostomy (12.3%), or an appendicostomy (5.4%). Most felt uncomfortable (80.4%) or felt they lacked competence in caring for these patients (81.8%). Most (64.3%) felt that ARMs should be discussed in residency. Only 1 physician (1.7%) answered all questions in the knowledge assessment correctly; 33.9% did not answer any question correctly. On subgroup analysis, more physicians who had completed a pediatric and adolescent gynecology rotation recalled learning about ARMs (83.3% vs 51.9%, <em>P</em> = .03); however, there were no differences in experience, comfort, competence, or willingness to learn.</div></div><div><h3>Conclusion</h3><div>OB/GYN providers report a lack of knowledge and comfort in caring for patients with ARMs. Development of a standardized OB/GYN residency curriculum and education for practicing OB/GYN physicians is necessary to allow access to knowledgeable sexual and reproductive health for this patient population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 68-74"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mother-Daughter Dyads’ Perceptions of Contraception","authors":"Caroline L Katzman MD ,&nbsp;Jessica C Sims MD ,&nbsp;Julen N Harris MD, MPH ,&nbsp;Susan L Rosenthal PhD ,&nbsp;Jenny KR Francis MD, MPH","doi":"10.1016/j.jpag.2024.09.005","DOIUrl":"10.1016/j.jpag.2024.09.005","url":null,"abstract":"<div><h3>Study Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>Dyads were recruited from an adolescent medicine clinic in Dallas, TX. A semistructured joint interview was conducted with each dyad. Interviews were recorded, transcribed, and coded through an iterative approach.</div></div><div><h3>Results</h3><div>There were 11 dyadic interviews (22 participants). Sources of information about contraception included mothers, healthcare providers (HCPs), friends/family, school, and individualized learning. Dyads identified distinct purposes and limitations of each source. Mothers noted the importance of supporting their daughter's development and specific needs. Often these conversations began with a discussion of menstrual management. Information from friends/family was overwhelmingly anecdotal. Schools and HCPs were viewed as trusted sources, and the internet/social media as possibly inaccurate or misleading. Dyads described several risks and benefits of different methods. Minimal conflict was noted.</div></div><div><h3>Conclusion</h3><div>These results provide rich information about how mother-daughter dyads view contraception in joint discussion. It is important to ensure that accurate stories about contraception are accessible and teaching health literacy would be helpful. Menstrual management appears to be an acceptable starting point to discuss contraception. Schools and HCPs are trusted sources and measures should be taken to ensure teaching is accurate, developmentally appropriate and teaches evaluation of online information. Regardless of parental consent laws for adolescent contraception, engaging caregivers in the process can help support adolescent contraceptive decision-making.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 79-84"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual and Reproductive Health Goals and the 2030 Global Agenda for Sustainable Development: Progress, Prospects, and Challenges","authors":"Areej Hassan MD, MPH ,&nbsp;Sarah Golub MD, MPH","doi":"10.1016/j.jpag.2024.09.002","DOIUrl":"10.1016/j.jpag.2024.09.002","url":null,"abstract":"<div><div>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 (SDG) 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 Sustainable Development Goal targets and indicators with a 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.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 13-17"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Ovary Preserving Procedure for Neonatal Ovarian Cysts","authors":"XiaoLi Chen,&nbsp;DuoTe Cai,&nbsp;Yi Chen,&nbsp;BinBin Yang,&nbsp;YueBin Zhang,&nbsp;QingJiang Chen,&nbsp;ZhiGang Gao","doi":"10.1016/j.jpag.2024.09.007","DOIUrl":"10.1016/j.jpag.2024.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>We aim to evaluate the long-term outcomes of ovarian preserving surgery for neonatal ovarian cysts.</div></div><div><h3>Method</h3><div>The clinical data of neonatal ovarian cysts treated in our hospital from January 2015 to December 2022 were retrospectively analyzed.</div></div><div><h3>Results</h3><div>Our study included 22 patients, of which 21 were unilateral and 1 was bilateral. There were 13 cases of simple cysts and 9 cases of complex cysts, and one cyst changed from simple to complex. The mean largest diameter of simple cysts was 5.7 ± 2.1 cm, and that of complex cysts was 4.6 ± 2.0 cm. There was no significant difference between the two groups (<em>P</em> = .2264). Among the 22 patients, 21 underwent laparoscopic cystectomy. The only patient with bilateral cysts underwent percutaneous drainage of the right simple cyst. Twenty-one histological specimens were reviewed, of which 18 (85.7%) contained viable ovarian tissues. Five cases lost follow-up after surgery, and the remaining 17 cases had a follow-up period of 6 months to 5 years. The last ultrasound follow-up showed that 9 cases had bilateral normal ovaries, and 8 cases lost the ipsilateral ovary. The ovarian preservation rate of simple cyst was 90% (9/10), which was significantly higher than that of complex cyst (12.5%, 1/8) (<em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>Simple cysts (≥4 cm) had an excellent prognosis, with a long-term ovarian preservation rate of 90%. The long-term ovarian preservation rate of complex cysts after surgery was relatively low. Our study suggested that surgical treatment did not increase the chances of preserving the ovaries of patients with complex cysts.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 35-38"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuation of the Levonorgestrel-Releasing Intrauterine Device Among Adolescents With Endometriosis","authors":"Jessica Y. Shim MD ,&nbsp;Carly E. Milliren MPH ,&nbsp;Amy D. DiVasta MD, MMSc","doi":"10.1016/j.jpag.2024.10.005","DOIUrl":"10.1016/j.jpag.2024.10.005","url":null,"abstract":"<div><h3>Study Objective</h3><div>To estimate the 1-year continuation rate of the levonorgestrel-releasing intrauterine device (LNG-IUD) in adolescents with endometriosis, and the frequency at which additional systemic hormonal treatment (HT) is utilized.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed of patients aged 12-21 years who underwent laparoscopy for endometriosis and LNG-IUD insertion at a single tertiary care institution between 2018 and 2021.</div></div><div><h3>Results</h3><div>We evaluated 224 adolescents (mean age = 17.0, SD = 1.8 years) who underwent LNG-IUD placement during laparoscopic evaluation for endometriosis. Stage I endometriosis was most common (84.4%), followed by stage II (13.0%). Of 221 with follow-up, 208 (94.1%) had HT added or continued postsurgery. The most common additional HT was norethindrone acetate (42.5%), followed by combined hormonal contraceptives (34.8%). The 1-year LNG-IUD continuation rate was 92.0%. There were 18 IUD removals (8%) by 1 year, and the median time to removal was 118 days (interquartile range = 159; range 8-293). Use of additional HT was associated with a lower hazard of IUD removal within the first year of use (hazard ratio = 0.19, 95% confidence interval: 0.06-0.56, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The majority of adolescents used the LNG-IUD with additional systemic HT for endometriosis management. While overall continuation was high, adolescents who were using LNG-IUD and HT were more likely to continue LNG-IUD than those who were not utilizing additional HT.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 85-88"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FIGIJ and NASPAG Advocacy Statement-Eliminating the Persistent Misconception of the “Virgin Hymen”","authors":"Judith Celine Simms-Cendan ,&nbsp;Angela G. Sison-Aguilar ,&nbsp;Mariela Orti ,&nbsp;Clara DiNunzio ,&nbsp;Anastasia Vatopoulou ,&nbsp;Ellen Rome ,&nbsp;Michalina Drejza ,&nbsp;Jasmin Jayasinghe ,&nbsp;Daniela Ivanova Panova ,&nbsp;Marisa Labovsky","doi":"10.1016/j.jpag.2024.08.014","DOIUrl":"10.1016/j.jpag.2024.08.014","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 11-12"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}