Journal of pediatric and adolescent gynecology最新文献

{"title":"What Now?","authors":"Rosemary Claire Roden MD","doi":"10.1016/j.jpag.2025.03.001","DOIUrl":"10.1016/j.jpag.2025.03.001","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 3","pages":"Pages 311-312"},"PeriodicalIF":1.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917716","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":"Non-Ablative Radiofrequency and Vaginal Dilation Therapy.","authors":"Ana Maria Luna Ramalho, Claudia Cristina Takano, Mila Torii Corrêa Leite, Marair Gracio Ferreira Sartori","doi":"10.1016/j.jpag.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.04.009","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency (RF) is indicated for degenerative processes that involve decreased or delayed metabolism, blood flow, and nutrition, typically associated with chronic conditions. This study evaluated the effects of non-ablative radiofrequency (RF) combined with vaginal dilation in patients with vaginal agenesis or vaginal stenosis.</p><p><strong>Methods: </strong>Ten patients were divided into two groups: five received RF combined with dilation (VD+RF group), and five underwent only vaginal dilation (VD group). The RF treatment involved applying radiofrequency at 39°C for 5 minutes before dilation, while the VD group had dilation alone for 20 minutes.</p><p><strong>Results: </strong>No significant differences between the groups in final vaginal length and diameter were found. However, the VD+RF group exhibited a significant increase in vaginal length during sessions compared to the VD group. Improved comfort and reduced pain during dilation in the VD+RF group were attributed to the thermal effects of RF, which enhanced tissue elasticity and extensibility. Pain reduction during dilation was reported by all participants in the VD+RF group, whereas issues such as canal stenosis and emotional challenges were noted in both groups. The Visual Analog Scale for Satisfaction showed a significant improvement in sexual satisfaction in the VD+RF group compared to the VD group (p = 0.0422). Although the Female Sexual Function Index questionnaire revealed improvements in sexual function domains, it was only administered to a subset of sexually active women in the RF group.</p><p><strong>Conclusion: </strong>RF is as a safe and effective adjunct to vaginal dilation, enhancing pain management and sexual satisfaction.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041093","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":"Characteristics and Preoperative Management of Adolescent Patients with Pathology-Confirmed Endometriosis: A Multi-Institutional Study.","authors":"Katherine C Bergus, Brenna Rachwal, Lindsey Asti, Lesley L Breech, Yuan Yuan Gong, S Paige Hertweck, Holly R Hoefgen, Anne H Horne, Ashli Lawson, Seema Menon, Kathleen E O'Brien, Shashwati Pradhan, Yolanda R Smith, Priya Suvarna, Sarah Van Son, Geri Hewitt","doi":"10.1016/j.jpag.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.04.003","url":null,"abstract":"<p><strong>Study objective: </strong>This multi-institutional, observational, retrospective cohort study aimed to characterize the demographics and preoperative medical management of patients with pathology-confirmed endometriosis.</p><p><strong>Methods: </strong>We reviewed patients <22 years at 8 tertiary care pediatric hospitals in the Midwestern United States who underwent diagnostic laparoscopy and had biopsy-confirmed endometriosis. Patients were identified through pathology records. Demographics, medical history, clinical symptoms, and prior medical management were extracted. Descriptive statistics were computed.</p><p><strong>Results: </strong>Among 305 patients, median age at first presentation to pediatric and adolescent gynecology (PAG) was 15.6 years (interquartile range: 14.2-17.1). Most patients were White (83.3%) and most had commercial insurance (70.5%). Only 4.3% had a diagnosis of endometriosis prior to their initial presentation to PAG. Common symptoms included progressive dysmenorrhea (76.7%), heavy menstrual bleeding (50.8%), missed school/activities due to dysmenorrhea (55.1%). Patients sought care for their symptoms from a range of providers in addition to PAG, including primary care/adolescent medicine (75.1%), gastroenterology (18.7%), adult gynecology (22.3%), and physical therapy (13.4%). Nearly all patients (92.8%) tried oral hormonal menstrual suppression prior to laparoscopy. Hormonal management included combined oral contraception (62.3%), medroxyprogesterone acetate injection (15.7%), ≤5mg daily norethindrone (14.8%), >5mg daily norethindrone (13.4%), hormonal intrauterine system (13.1%), and contraceptive implant (5.3%).</p><p><strong>Conclusions: </strong>Patients with pathology-proven endometriosis typically presented with progressive dysmenorrhea, missed school or activities, and heavy menstrual bleeding. They sought care from a variety of providers and while most tried hormonal management of symptoms, the method used varied.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023695","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":"Artificial Intelligence (AI) and the Journal of Pediatric and Adolescent Gynecology (JPAG).","authors":"Paula J Adams Hillard","doi":"10.1016/j.jpag.2025.04.010","DOIUrl":"10.1016/j.jpag.2025.04.010","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024286","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":"Stenosis of Sigmoid Neovagina with Subsequent Pelvic Infection and Surgical Excision.","authors":"Taylore King, Cynthia Abam, Emily Trautner, Elissa Trieu, Laura Ramirez-Caban","doi":"10.1016/j.jpag.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.04.008","url":null,"abstract":"<p><p>Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome involves Müllerian abnormalities including agenesis of the upper vagina. Patients often elect for the creation of a neovagina, which can be performed via intestinal vaginoplasty to allow for penetrative sexual intercourse. We present a case of a 38-year-old female with MRKH who underwent sigmoid vaginoplasty and presented 12 years later with diffuse neovaginal closure, resulting in pelvic abscess formation and sepsis. She ultimately required surgical excision of the sigmoid neovagina for source control of the infection. This case highlights the importance of lifelong aftercare following vaginoplasty and incorporation of multidisciplinary teams in medically complex patients with complications from neovagina reconstruction.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025677","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":"Physical activity may attenuate the association of early adolescent adiposity with PCOS assessed in later adolescence: findings from a prospective cohort, Project Viva.","authors":"Rachel C Whooten, Sheryl L Rifas-Shiman, Wei Perng, Jorge E Chavarro, Emily Oken, Marie-France Hivert","doi":"10.1016/j.jpag.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.04.011","url":null,"abstract":"<p><strong>Objective: </strong>To assess how moderate-vigorous physical activity (MVPA) may modify the association of early adolescent adiposity with late adolescent polycystic ovary syndrome (PCOS).</p><p><strong>Methods: </strong>Within the Project Viva prospective cohort, we assessed the association of body mass index z-score (BMIz) at early adolescence (mean age 13.1 years) with later PCOS (self-reported diagnosis or oligo-anovulation with clinical/biochemical hyperandrogenism) at mean age 17.7 years. We stratified our analyses by tertile of actigraphy-assessed moderate-vigorous physical activity (MVPA) during early adolescence . In multivariable logistic regression models, we adjusted for maternal education and PCOS, child race and ethnicity, and child health behaviors.</p><p><strong>Results: </strong>Among 341 female adolescents, n=47 (14%) met criteria for PCOS in late adolescence. In early adolescence (∼13 years old), mean (SD) BMIz was 0.32 (1.10) units and mean (SD) MVPA was 27.1 (17.9) min/day. After adjusting for covariates, early adolescent BMIz was associated with later PCOS (OR=1.72 95%CI=1.15, 2.56 per unit increase in BMIz). In stratified analyses, the association of early adolescent BMIz with later PCOS was apparent for those in the lowest tertile of MVPA (OR 3.22; 95% CI 1.25, 8.31) however was weaker among those more active (MVPA tertile 2 OR = 1.65; 95% CI 0.74, 3.67 and tertile 3 OR=1.34; 95% CI=0.63, 2.86, respectively).The interaction term p-value was non-significant (p=0.36).</p><p><strong>Conclusion: </strong>Our findings suggest that the detrimental effect of adiposity in relation to PCOS risk is most apparent only among those with lower MVPA. Maintaining adequate MVPA during the early teen years may mitigate PCOS risk associated with excess adiposity.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031104","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":"Social Support Related to Menses in Gender-Diverse Adolescents: A Qualitative Study.","authors":"Christopher Garrick, Benjamin Bear, Meghan Gannon, Anne E Kazak, Julia Eisenberg, Yasaman Alibabaee, Beth I Schwartz","doi":"10.1016/j.jpag.2025.04.006","DOIUrl":"10.1016/j.jpag.2025.04.006","url":null,"abstract":"<p><strong>Study objective: </strong>Menses in transgender or gender-diverse people can cause dysphoria, which has been linked to various comorbid conditions including depression, anxiety, and suicidal ideation. Although social support is thought to be beneficial for adolescents in general, little is known about its effects on gender-diverse adolescents (GDAs) receiving care. Thus, this study sought to document the effects of social support on the menses management experiences for GDAs and highlight how such support influences their access to and satisfaction with gender-affirming care.</p><p><strong>Methods: </strong>Participants were recruited from a tertiary care children's hospital to participate in semi-structured phone interviews. Eligibility included adolescents who were 12-20 years of age and had undergone menarche. Interviewers asked respondents about the impact of menses on their mental health, relationships, daily activities, and experiences with menses management and suppression.</p><p><strong>Results: </strong>A total of 36 individuals participated, with a mean age of 16.82 (SD 2.02) years. Six major themes were identified related to social support: Types of Support, Support Persons within the Social Network, School Environment, Medical Providers as a Social Support, Resources, and Advice for Others.</p><p><strong>Conclusion: </strong>This study highlights the vital role of social support as GDAs navigate gender-affirming care and menses management. The exploration of various sources of support-such as family, peers, and health care providers-emphasizes the importance of safe, affirming environments for GDAs. Clinicians as perceived support have a unique opportunity to foster shared decision-making and health advocacy by using preferred pronouns, recognizing dysphoria triggers, and considering GDAs' perspectives when developing care plans.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968359","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":"Young People's Perceptions of Why Sexually Active Peers May Not Use Prescribed Contraception.","authors":"Brooke Whitfield, Zoe H Pleasure, Renee M Odom-Konja, Cambray Smith, Subasri Narasimhan, Tracey A Wilkinson, Laura D Lindberg","doi":"10.1016/j.jpag.2025.04.004","DOIUrl":"10.1016/j.jpag.2025.04.004","url":null,"abstract":"<p><strong>Study objective: </strong>Access to contraception is a necessary component of reproductive autonomy for adolescents and young adults (AYAs). AYAs persistently face barriers to accessing confidential, affordable contraception. In this study, we characterize and describe the most common reasons AYAs perceive that their sexually active peers might not use prescribed contraception.</p><p><strong>Methods: </strong>Using a cross-sectional national text-based survey of AYAs aged 14-24, we conducted a content analysis of open-ended text responses to a question about why AYAs' sexually active peers might not use prescribed contraception (n = 554). We identified the most common reasons for non-use and examined differences in reported reasons for non-use by demographic factors.</p><p><strong>Results: </strong>AYAs reported that their sexually active peers may not use prescribed contraception because they have concerns about it being harmful, they may be stigmatized for using contraception, and it can be logistically difficult for AYAs to obtain. Older and pregnancy-capable respondents were more likely to perceive contraceptive harm as a reason for prescribed contraception non-use (P < .05) but were less likely to perceive stigma and logistical barriers as a reason for non-use (P < .05) compared to younger and pregnancy-incapable respondents.</p><p><strong>Conclusion: </strong>We found that perceptions of contraceptive non-use by peers vary by respondents' age and pregnancy capability, likely due to differences in exposure to contraception information in peer groups and their own contraceptive use experiences. Understanding AYAs' perceived reservations towards prescribed contraception is vital to inform clinicians' counseling conversations and for public health messaging.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970718","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":"Availability of Inpatient Sexual and Reproductive Health Services at U.S. Children's Hospitals.","authors":"Sarah A Golub, Alissa Roberts, Colleen McCarty, Erin Sullivan, Sahar N Rooholamini, Taraneh Shafii","doi":"10.1016/j.jpag.2025.04.005","DOIUrl":"10.1016/j.jpag.2025.04.005","url":null,"abstract":"<p><strong>Objective: </strong>To understand the scope of sexual and reproductive health (SRH) services provided to adolescents assigned female at birth in pediatric hospitals in the United States.</p><p><strong>Methods: </strong>Data were collected via an electronic survey of inpatient clinical leaders at freestanding and nested children's hospitals in the United States. Survey domains included availability of trained clinicians, equipment to perform pelvic exams, contraceptive methods offered, and facilitators and barriers in providing SRH services. Descriptive statistics were used for analysis.</p><p><strong>Results: </strong>Of 160 invited hospitals, 52 (33%) responded with 25 (48%) surveys completed by Pediatric Hospital Medicine and 23 (44%) Adolescent Medicine specialists. Twenty-two (42%) worked in free-standing and 30 (58%) in nested children's hospitals with 42 (81%) reporting academic- or university-affiliations. Only 3 (6%) reported having the equipment needed to perform pelvic exams on the inpatient unit. Eleven (21%) reported providing some form of long-acting reversible contraception, of which all provided implants; only 5 (10%) institutions offered intrauterine device insertion. A common facilitator was having clinicians with required skills (65%) and a common barrier was SRH not being considered an inpatient problem (83%).</p><p><strong>Conclusion: </strong>While clinicians identify SRH services at children's hospitals as important, many lack the basic equipment needed and institutional support to provide comprehensive SRH care. This study suggests that the integration of clinicians appropriately trained in SRH care may be one of the greatest facilitators to providing inpatient SRH care in children's hospitals.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012621","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":"Polish Mothers and Cervical Cancer Prophylaxis: What Do They Know and What Attitude Do They Have Toward Human Papillomavirus Vaccination?","authors":"Karina Matusiak, Zana Bumbuliene","doi":"10.1016/j.jpag.2025.04.002","DOIUrl":"10.1016/j.jpag.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to assess the knowledge and awareness of cervical cancer primary and secondary prophylaxis among our patients' mothers, and their attitude toward human papillomavirus (HPV) vaccination.</p><p><strong>Methods: </strong>During patients' appointments at Children's Memorial Health Institute Pediatric and Adolescent Gynecology Clinic in Warsaw we asked 234 mothers (aged <20-60) to complete a self-prepared survey. The data were analyzed using t-student test and chi-square test.</p><p><strong>Results: </strong>Only 61.5% of respondents correctly indicated the purpose of cervical cytology. Similarly, 67.9% claimed that it should be performed annually, and 79.4% that till the end of life. Although 87.6% of answerers have heard about HPV vaccination, still 69.3% of them were willing to get more information. Physicians were considered the most reliable source of knowledge about HPV vaccination and had a relevant impact on mothers' decision to vaccinate (P < .05). Nearly all respondents (92.7%) weren't vaccinated against HPV. Still, 57.3% declared willingness to vaccinate their children. The vaccine skeptics indicated that they had too little information (59%), feared side effects (45%), and doubted HPV vaccine effectiveness (23%). Mothers aged 40 and older and with higher education had greater knowledge about cervical cancer screening (P < .05) and were more willing to vaccinate their children (P < .05).</p><p><strong>Conclusion: </strong>Since cervical cytology was invented 100 years ago, knowledge about this screening test is low. The HPV vaccine is well-recognized and well-accepted, but most respondents lack information. Consequently, it is crucial to initiate multidirectional educational actions to raise awareness about cervical cancer and its prophylaxis.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023191","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}