Journal of pediatric and adolescent gynecology最新文献

{"title":"42. Fertility intentions among transgender and non-binary youth","authors":"Julia Eisenberg ,&nbsp;Sarah Felleman ,&nbsp;Beth Schwartz ,&nbsp;Benjamin Bear ,&nbsp;Anne Kazak ,&nbsp;Rebecca Mercier","doi":"10.1016/j.jpag.2025.01.075","DOIUrl":"10.1016/j.jpag.2025.01.075","url":null,"abstract":"<div><h3>Background</h3><div>Transgender and non-binary individuals may experience gender dysphoria, distress associated with the incongruence between one's gender identity and sex assigned at birth. Gender-affirming treatments are used to alleviate gender dysphoria by facilitating physical changes more closely aligned with one's gender identity but may affect fertility. Research investigating the fertility intentions of transgender and non-binary adolescents is limited, with no studies of non-binary youth. Our objective was to assess fertility intentions and future parenting goals in a cohort of gender diverse adolescents seen in a multidisciplinary pediatric gender program and assess how those goals differ by gender identity.</div></div><div><h3>Methods</h3><div>This is a retrospective chart review of all gender diverse patients who were seen at the Nemours Gender Wellness Program from 2015-2020. Abstracted data include patient demographics, fertility intentions, referrals, and procedures. Descriptive statistical analysis was performed using frequency counts, percentages, medians and standard deviations. Comparisons were made between transgender and gender non-binary patients. Categorical variables were compared using chi-square and Fisher exact tests; continual variables were compared with t-tests or mann-whitney testing as appropriate for non-parametric variables.</div></div><div><h3>Results</h3><div>Of the 189 included patients, most were White (83%) and non-Hispanic (90%). Participant ages ranged from 5-18 years, with a median of 15.00 (SD 2.5) years. 168 (88%) individuals identified as transgender and 21 (11%) as non-binary. Of the participants that discussed fertility intention during their visit, more transgender adolescents were interested in future parenting than non-binary youth (35% vs. 20%, p=0.01). The majority of participants from both groups did not express any interest in current parenting (100%), future pregnancy (95%) or desire for biological children (59%). However, 31% of participants were interested in a Reproductive Endocrinology and Infertility consult and/or fertility preservation procedure, with no differences between groups.</div></div><div><h3>Conclusions</h3><div>Within our cohort, transgender individuals were more likely than non-binary individuals to express an interest in future parenting. Despite this, most patients in both groups were not interested in biological children or fertility preservation. Understanding fertility intentions among gender diverse adolescents can help inform counseling on gender-affirming care and improve treatment strategies for this population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 249"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520848","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":"28. Differences in Vaginoplasty When Performed in Childhood Versus Adulthood: A National Surgical Quality Improvement Program Study","authors":"Jourdin Batchelor ,&nbsp;Frances Grimstad ,&nbsp;Ava Scatoni ,&nbsp;Elizabeth Boskey ,&nbsp;Jessica Shim","doi":"10.1016/j.jpag.2025.01.061","DOIUrl":"10.1016/j.jpag.2025.01.061","url":null,"abstract":"<div><h3>Background</h3><div>Vaginoplasties are performed for a variety of congenital or acquired indications from childhood through adulthood. There are considerable gaps in understanding whether the conditions treated by vaginoplasty or the associated risk of complications differ between pediatric and adult patients. This study aimed to assess types of vaginoplasties, underlying diagnoses, and complication rates in children and adults using large multicenter databases.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized data from the American College of Surgeons National Surgical Quality Improvement Program adult and pediatric databases from 2012 to 2021. Children (aged &lt; 18 years) and adults (greater than or equal to 18 years) who underwent vaginoplasty for any reason were identified using Current Procedural Terminology (CPT) codes for vaginoplasties performed. Multivariable logistic regression analyzed differences in diagnoses, surgeon specialties, and 30-day complications. This study was exempt from Institutional Review Board approval.</div></div><div><h3>Results</h3><div>We identified 232 children (mean age 6.2 years) and 209 adults (mean age 36.7 years) who underwent vaginoplasty. Surgical specialty differed between children and adults. Pediatric urology performed the majority of vaginoplasties in children, whereas plastic surgery performed the majority in adults (75% vs 70%, p&lt; 0.001). Gynecology performed a similar percentage of procedures in both groups. The type of vaginoplasty also varied. Children underwent vaginoplasties coded as both with and without grafts (57291, 57292, 57335), but adults only underwent vaginoplasties coded with grafts (57335). Surgical indication also significantly differed with 97% of childhood vaginoplasties being for urethrovaginal conditions and 85% of adult vaginoplasties being for gender dysphoria. Overall, 30-day complications were comparable and relatively low in both groups. Adults were more likely to have a documented wound dehiscence (0% vs 5%; p&lt; 0.001). Wound dehiscence occurred in isolated urethrovaginal procedures and gender dysphoria cases, with 82% of all disruptions found in the latter group.</div></div><div><h3>Conclusions</h3><div>We identified differences in surgery type, surgeon specialty, and diagnoses when comparing vaginoplasties performed in children and adults. Although complications were low overall, wound dehiscence was more common in adults, likely due to complexity in gender affirming vulvovaginoplasties. More research is needed to understand these differences, to optimize surgical techniques, and improve patient care across all ages.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 243-244"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519868","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":"55. Incidence, Indications, and Complications of Cesarean Delivery Among Adolescent Childbirths: National Inpatient Sample 2019-2021","authors":"Ting Yu Wu,&nbsp;Margarita Berwick","doi":"10.1016/j.jpag.2025.01.088","DOIUrl":"10.1016/j.jpag.2025.01.088","url":null,"abstract":"<div><h3>Background</h3><div>Cesarean deliveries in the United States have increased over the recent decades. The impact of this increase on the adolescent population has not been precisely defined.</div></div><div><h3>Methods</h3><div>We performed a 3-year cross-sectional analysis of cesarean deliveries in individuals aged 10 to 19 years captured in the National Inpatient Sample from 2019 to 2021.</div></div><div><h3>Results</h3><div>Cesarean deliveries in individuals aged 10-19 represented 2.67 % of all cases. Geographically, over half of adolescent births occurred in rural areas (57.3 %), followed by urban areas (25.7 %), and least frequently in suburban regions (16.9 %). 38.9% of the individuals in the sample were identified as White, 29% as Hispanic, and 26.1 % as Black. Multifetal gestations accounted for 2.9 %. Among the most common diagnoses associated with cesarean, non-reassuring fetal status was documented in 41.4 % of cases, labor dystocia in 27 %, and repeat operation in 11.3 %. Notably, the incidence of failed TOLAC was 21.6 %. Incidence of commonly noted delivery complications was 10.7 % for meconium in amniotic fluid, 6 % for chorioamnionitis, 3.2 % for placental abruption, 2.9 % for multifetal gestation, and 2 % for malpresentation. Common maternal complications included anemia at 23 %, obesity at 15.4 %, mental health disorders at 11.1 %, gestational hypertension at 8.8 %, postpartum hemorrhage at 4.4 %, and blood transfusion at 3.5 %. Among severe complications, cases of placenta accreta spectrum, hysterectomy, and bowel or bladder injury were noted, though the incidence was very small (less than 0.1 % for all).</div></div><div><h3>Conclusions</h3><div>Cesarean delivery in adolescents is common, with indications similar to those previously reported in adult populations. Complications, including severe complications like placenta accreta disorders, organ injuries, and hysterectomy, did occur in this age group. Given the risk of complications and potential for future morbidity from repeat cesareans, monitoring rates of cesarean delivery in this age group and efforts for safe prevention of primary cesarean are warranted. These findings reaffirm the need to provide comprehensive obstetric and neonatal care to address complex health issues surrounding childbearing in this age group.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 255"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520117","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":"31. Effective Management of Multi-Resistant Neonatal Breast Abscess Through Early and Precise Care.","authors":"Carolina Pastene ,&nbsp;Claudia Moya ,&nbsp;Mónica Muñoz ,&nbsp;Magdalena Castro ,&nbsp;Carolina Carrasco ,&nbsp;Camila Yañez ,&nbsp;Isabel Fuentealba","doi":"10.1016/j.jpag.2025.01.064","DOIUrl":"10.1016/j.jpag.2025.01.064","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal breast abscess is a rare but significant condition, typically occurring in full-term infants due to the spread of skin flora, often Staphylococcus aureus, to the breast parenchyma. This condition, if not treated promptly, can result in serious complications such as breast hypoplasia or scarring. Recognizing early signs and appropriate management are crucial for a favorable outcome.</div></div><div><h3>Case</h3><div>We present the case of a 1-month-old female infant, full-term at 39+5 weeks gestation, with no prior medical history or hospitalizations, and up-to-date on her immunizations. She developed a right-sided breast abscess, presenting with a firm, warm, erythematous swelling with induration and tenderness. The patient had no fever but was tachycardic. Laboratory results showed a white blood cell count of 19.55 × 10³/µl and C-reactive protein of 25 mg/L. Breast ultrasound revealed a poorly defined hypoechoic lesion measuring 30 × 22 mm with a central, irregular liquid collection of 13 × 10 mm. Despite intravenous Cloxacillin, the patient showed no improvement by the third day. Surgical drainage was performed with the support of interventional radiology, extracting 2 cc of pus under ultrasound guidance. Cultures revealed multi-resistant Staphylococcus aureus. Vancomycin treatment was initiated, with dose adjustments made after the fifth dose. The infant was treated successfully, followed by a 10-day course of oral Cotrimoxazole. Full recovery was observed, with no further complications. Ethics Approval: This case was reviewed and approved by the Ethics Committee of Hospital Dr. Luis Calvo Mackenna, in accordance with institutional guidelines.</div></div><div><h3>Comments</h3><div>This case emphasizes the importance of early diagnosis, timely surgical intervention, and the selection of appropriate antibiotic therapy, particularly in cases involving multi-resistant pathogens. Prompt treatment is critical to prevent complications such as damage to developing breast tissue. The adjustment of antibiotic dosing in young infants, as demonstrated with Vancomycin in this case, is crucial due to their unique pharmacokinetics, ensuring therapeutic effectiveness while minimizing toxicity. Additionally, the role of interventional radiology in enhancing precision during abscess drainage in neonatal patients is highlighted, contributing to successful outcomes and minimizing potential complications. Financial Disclosure: The authors have no financial relationships relevant to this case to disclose.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 244-245"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519871","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":"11. Addressing Cervical Cancer Disparities in Adolescents with Disabilities through HPV Vaccination","authors":"Theresa Rager,&nbsp;William Gillespie,&nbsp;Harlan Mccaffery,&nbsp;Melina Dendrinos,&nbsp;Kate McCracken,&nbsp;Monica Rosen","doi":"10.1016/j.jpag.2025.01.044","DOIUrl":"10.1016/j.jpag.2025.01.044","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents with disabilities (AWD) are often viewed as nonsexual, posing challenges in receiving sexual healthcare. Yet, patients with disabilities have higher rates of sexual abuse and unprotected sex and lower rates of cervical cancer screening. It is critical that AWD receive the HPV vaccination due to their risk of HPV exposure and lower likelihood of receiving routine cervical cancer screening. This study aims to assess if there is a discrepancy in HPV vaccination between AWD and their non-disabled peers.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted of adolescent females ages 16-21 years attending any visit in an academic health system from July 2021 - September 2024. Data collected included demographics, disability status, and receiving at least one dose of the HPV vaccine. Disability status was defined by the Children with Disabilities Algorithm (Agency for Healthcare Research and Quality), which uses ICD-9 codes to classify physical, sensory, developmental/behavioral, psychological, and intellectual disabilities. The primary outcome was differences in HPV vaccination between adolescents with specific disabilities, any disability, and non-disabled peers. Analysis included Chi-square tests and logistic regression. This study was exempt by IRB.</div></div><div><h3>Results</h3><div>Of 7,801 total adolescents, 1,132 (14.5%) were identified as having any disability, 5,785 (74.2%) of all patients received at least one dose of the HPV vaccine, and 870 (76.9%) patients with disabilities received at least one dose. Any disability was associated with higher HPV vaccination rate (p=0.025). Psychological and sensory disabilities were significantly associated with higher HPV vaccination rates (p=0.011; p=0.039), whereas intellectual disability was nearly significantly associated with lower HPV vaccination rates (p=0.07). Physical and developmental disabilities were not associated with HPV vaccination. Compared to white race, non-Black racial minorities had a significantly higher HPV vaccination rate (p=0.031). There was no significant difference between HPV vaccination among disabilities according to race. Older age was significantly associated with HPV vaccination (p=0.006). See Table 1.</div></div><div><h3>Conclusions</h3><div>Adolescents with psychological and sensory disabilities had higher HPV vaccination rates, suggesting lower cervical cancer risk. However, adolescents with intellectual disabilities may experience lower rates, exposing a potential disparity in cervical cancer risk. Providing patients and parents with education on HPV exposure and cancer risk tailored to the adolescent's disability may decrease barriers to HPV vaccination.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 234-235"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519769","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":"7. Fertility Attitudes and Turner Syndrome","authors":"Lauren Roth ,&nbsp;Madeline Ross ,&nbsp;Anne-Marie Priebe ,&nbsp;Jacqueline Maher ,&nbsp;Veronica Gomez-Lobo ,&nbsp;Tazim Dowlut-McElroy","doi":"10.1016/j.jpag.2025.01.019","DOIUrl":"10.1016/j.jpag.2025.01.019","url":null,"abstract":"<div><h3>Background</h3><div>Primary Ovarian Insufficiency is the main reproductive effect in individuals with Turner syndrome (TS). Guidelines recommend disclosure of reduced fertility in individuals with TS and counseling inclusive of options for fertility preservation and family planning. Although ovarian tissue cryopreservation (OTC) and oocyte cryopreservation (OC) are offered to individuals with TS, live births rates remain unknown. Also unknown are the attitudes of adolescents and young adults with TS (AYA-TS) and their parents regarding future fertility. The objective of this study was to compare differences in attitudes between AYA-TS and their parents regarding future fertility and fertility preservation.</div></div><div><h3>Methods</h3><div>After IRB approval, we conducted two studies in sequence of 12- to 25-year-olds with TS and their parents. First, to maximize acceptability/applicability of the Fertility ConcepTS questionnaire, a two-staged Delphi Procedure was implemented during 3 focus groups with AYA-TS and parents to develop/ refine survey questions. Second, a finalized cross-sectional survey was distributed via a social media platform of the Turner Syndrome Global Alliance and during a multidisciplinary TS clinic. Statistical analysis was performed using SPSS. Statistical significance was defined as P &lt;.05.</div></div><div><h3>Results</h3><div>A total of 28 participants were included in the analysis. Sixteen (57%) were AYA-TS and 12 (43%) were parents (Table 1). The median age of AYA-TS was 17.5 (IQR 10.5) years and of parents was 48.0 (IQR 9.3) years. AYA-TS and parents did not differ in their interest in understanding the effects of TS on fertility and pregnancy, their interest building a family, their desire for awareness of the possibility of biological children, and their awareness that feelings about building a family might change (Table 2). AYA-TS and their parents differed in their consideration for adoption (p=.005), use of donor egg (p&lt;.001), use of a gestational carrier (p&lt;.001) and raising a child as a single parent (p=.002). While 6.3%, 18.8%, 37.5% and 31.3% of AYA-TS disagreed/strongly disagreed with adoption, donor egg, gestational carrier, and single parenthood, respectively, all parents agreed/strongly agreed. AYA-TS and their parents differed in their consideration for OC (p=.042), OTC (p=.021), and awareness of change in opportunity for OC/OTC (p=.002). Although all parents agreed/strongly agreed, 18.8%, 43.8%, and 18.5% of AYA-TS, respectively, disagreed/strongly disagreed with OC, OTC, and awareness of change in opportunity for OC/OTC.</div></div><div><h3>Conclusions</h3><div>AYA-TS and their parents have differing attitudes about fertility and fertility preservation. Counselling should include consideration of the needs of AYA-TS alongside parent priorities.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 223"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520006","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":"29. Early growth in first trimester scan in adolescent pregnancies: Results from a comparative cohort study.","authors":"Anastasia Vatopoulou ,&nbsp;Athina Samara ,&nbsp;Hara Skentou ,&nbsp;Katerina Dadouli ,&nbsp;Fani Gkrozou ,&nbsp;Antonios Garas ,&nbsp;Sotirios Sotiriou","doi":"10.1016/j.jpag.2025.01.062","DOIUrl":"10.1016/j.jpag.2025.01.062","url":null,"abstract":"<div><h3>Background</h3><div>In the present study we aim to assess the Crown-rump length (CRL) values measured in first trimester scan in adolescent pregnancies compared with the respective CRL values in adult pregnancies.</div></div><div><h3>Methods</h3><div>All consecutive pregnancies that underwent a first trimester ultrasound scan in two fetomaternal units in Greece during a twelve-year period were included in the present study. Ultrasound findings, demographic characteristics and medical records were retrospectively reviewed and recorded in an anonymous database. Cases with a maternal age&lt; 20 years were characterized as adolescent pregnancies, and all other cases were grouped as adult pregnancies (control group). All statistical analyses were performed using R (version 4.2.2) software packages. The Kolmogorov-Smirnov test was used to test the normality of the variables. Multivariate linear regression model and linear regression model were used to assess the association between the weighted for gestational age CRL and the independent variables. The results are represented as the effect size of the CRL. Statistical significance was set at P&lt; 0.05 (two tailed).</div></div><div><h3>Results</h3><div>In total, 3234 pregnancies were included in the present study; 325 were identified as adolescent pregnancies and 2909 were adult pregnancies. In multivariate analysis, CRL values were statistically significant lower (52.6 mm and 58.8 mm respectively) in adolescent pregnancies (p&lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Based on our results, pregnancy in adolescents has been associated, with statistically significant lower CRL measures compared with adult pregnancies. More prospective studies with larger cohort series are needed.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 244"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519869","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":"3. A novel approach for controlled drainage of giant ovarian cysts through mini-laparotomy","authors":"Victoria Huynh ,&nbsp;Megan Sumida ,&nbsp;Kathleen McDowell Takahashi ,&nbsp;Ana Cisneros-Camacho ,&nbsp;Amitha Ganti ,&nbsp;Jennifer Bercaw-Pratt ,&nbsp;Sanjeev Vasudevan ,&nbsp;Olivia Winfrey","doi":"10.1016/j.jpag.2025.01.036","DOIUrl":"10.1016/j.jpag.2025.01.036","url":null,"abstract":"<div><h3>Background</h3><div>Large ovarian cysts in adolescents often present with low malignancy risk, prompting discussions about optimal surgical strategies. Minimally invasive methods aim to reduce complications, pain, hospitalization length, and scar appearance. As such, there is a desire to utilize less invasive approaches for the removal of large to giant masses. However, the advantages of minimally invasive surgery must be balanced with the risks of spillage, including malignant seeding and upstaging, chemical peritonitis, and recurrence. A few minimally invasive techniques have been proposed, including adherence of surgical gloves or bandages, controlled drainage with catheters, or use of the Alexis laparoscopic system. These techniques are poorly standardized and can fail to remain adherent during the case. We aim to describe a unique approach for the safe drainage of giant ovarian cysts.</div></div><div><h3>Case</h3><div>We present four adolescents with giant ovarian cysts (10-30 cm) and low pre-operative concern for malignancy, who proceeded to surgery for definitive treatment of the mass and associated symptoms. In all cases, a 4-6 cm midline infraumbilical incision was used. After obtaining adequate exposure of the mass, we adhered the rigid ring of a sterile 3 cm silo bag designed for ventral wall defects (Image 1) to a dried surface of the mass using sterile surgical glue. After ensuring the glue was dry, we trimmed off the closed distal end of the bag to allow access to the cyst surface. Through the constructed opening of the bag, the cyst was then entered sharply and contents were drained. In three cases, no spillage of contents was noted (Image 2) after multiple (1.9-5) liters were drained. In one case, there was minimal spillage noted due to malfunction of the suction device. In all but one case, the ovarian cortex was spared after cystectomy. In all cases, the bags remained firmly adherent to the ovarian cortex until the ovary and cyst could be exteriorized. There were no postoperative complications, and patients were discharged on postoperative days 0-2.</div></div><div><h3>Comments</h3><div>We introduce a safe, ovarian-sparing approach for extracorporeal drainage of giant adnexal cysts using a silo bag for spillage prevention through a mini-laparotomy incision. We believe this technique would be readily reproducible at many hospitals.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 230-231"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519878","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":"37. Examining contraceptive knowledge, use and preferences of adolescents hospitalized with psychiatric disorders","authors":"Abigail Underwood ,&nbsp;Alicia Bunger ,&nbsp;Brittny Manos ,&nbsp;Elise Berlan","doi":"10.1016/j.jpag.2025.01.070","DOIUrl":"10.1016/j.jpag.2025.01.070","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents with psychiatric symptoms have unique sexual health needs. These adolescents can have younger age at first sex, less frequent and/or inconsistent contraception use, and higher risk sexual behaviors than their peers without psychiatric symptoms. We examined contraception knowledge, use, and preferences among adolescents assigned female at birth (AFAB) hospitalized for psychiatric care, in addition to patient factors associated with contraceptive use.</div></div><div><h3>Methods</h3><div>Between November 2021 and March 2023, we recruited 451 adolescents AFAB ages 14-17 from 4 inpatient psychiatric units at a large children's hospital. As part of a larger study examining integration of contraception care in inpatient psychiatric settings, participants answered a survey about reproductive health, mental health, contraception knowledge, use, and preferences. The survey was administered via an electronic tablet using REDCap. Participants received a gift card incentive. Descriptive statistics included mean and standard deviation (SD) for continuous variables and frequencies and percentages for categorical variables. We used logistic regression to examine characteristics associated with contraception use. This study was approved by the institutional review board.</div></div><div><h3>Results</h3><div>Mean age was 16.1 (95% CI: 14.1-18.1); 65.4% identified as white and 9.3% identified as Hispanic. Most respondents reported knowledge about the contraceptive pill (98.9%), implant (76.1%), intrauterine device (IUD; 75.2%), and injectable (51.4%). Among the 44.6% of respondents that reported ever having intercourse, condoms (49.3%), withdrawal (29.4%) and contraceptive pills (23.4%) were the most common methods of contraception. Some (37.3%) reported using multiple methods and few (13.4%) reported using no method to prevent pregnancy. When asked to select their preferred method, participants chose contraceptive pills (38.6%) most, followed by the implant (16.0%) and IUD (11.3%). Age was significantly associated with contraceptive use (OR: 1.6; 95% confidence interval 1.3, 1.9; p&lt; 0.001) with older adolescents reporting higher odds of contraceptive use. Patient race, experience with sexual education, and insurance status were not significantly associated with contraceptive use.</div></div><div><h3>Conclusions</h3><div>Many adolescents hospitalized with psychiatric disorders are sexually active. Despite knowledge of contraceptives and preferences for more effective methods, their use of condoms and withdrawal may indicate their contraceptive needs are not being met. As adolescents face increasing rates of psychiatric symptoms, effort is recommended to ensure they have accessible sexual health services.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 247"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520015","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":"Urethral Prolapse in the Course of Cystic Fibrosis: A Case Report.","authors":"Anna Mordarska, Karolina Kowalczyk, Grzegorz Kudela, Agnieszka Drosdzol-Cop","doi":"10.1016/j.jpag.2025.02.009","DOIUrl":"10.1016/j.jpag.2025.02.009","url":null,"abstract":"<p><p>This case report highlights a rare occurrence of urethral prolapse (UP) in a 7-year-old girl diagnosed with cystic fibrosis (CF). The patient displayed a protruding, swollen, and bleeding mass at the urinary orifice, accompanied by chronic constipation and a recent respiratory syncytial virus (RSV) infection. Cystovaginoscopy and circumferential excision were performed, leading to a successful outcome. Since the operation, the patient has been pain-free. The association between CF and UP underscores the need for heightened awareness among clinicians. The report focuses on recognizing and managing UP in pediatric CF patients to provide the best possible care.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537329","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}