Pediatric and Adolescent Gynecology, An Issue of Obstetrics and Gynecology Clinics (The Clinics: Internal Medicine)

Cover......Page 1
Foreword......Page 2
Preface......Page 4
Dysmenorrhea......Page 6
Case 2: Obstructed Hemi-Vagina with Right Hematocolpos (Figs. 1B, 3-6)......Page 7
Case 3: Uterine Didelphys with Complete Longitudinal Vaginal Septum (Figs. 1C, 7)......Page 9
Case 4: Leiomyoma (Rare in This Age Group) (Figs. 8, 9)......Page 10
Pelvic mass/pain......Page 11
Case 5: Benign Dermoid (Teratoma) (Figs. 11-14)......Page 12
Genital irritation......Page 14
Case 7: Labial Hypertrophy (Figs. 16A, 16B. See also Case 13 Figs. 23, 24)......Page 15
Case 8: Vaginal Foreign Body (Figs. 17, 18)......Page 16
Case 9: Psoriasis of the Vulva (Fig. 19)......Page 17
Case 10: Vulvar Apthosis (Fig. 20)......Page 18
Case 12: Crohn’s Disease Fistula (Fig. 22)......Page 19
Case 13: Imperforate Hymen (Figs. 23-25)......Page 20
Case 14: Acquired Colpoclesis (Fig. 26)......Page 21
Case 15: Complete Androgen Insensitivity (Figs. 27, 28; Table 1)......Page 22
Case 16: (Utero) Vaginal Agenesis: Mayer-Rokitansky-Kuster-Hauser Syndrome (Figs. 29-31)......Page 24
Summary......Page 25
References......Page 26
Disorders of Sexual Development......Page 30
Acknowledgment......Page 31
Management: gender assignment......Page 36
Surgery......Page 38
Gonadectomy......Page 40
Medical......Page 41
Gender identity......Page 43
Surgical outcomes......Page 44
Psychosexual outcomes/quality of life measures......Page 45
Summary and future direction......Page 46
References......Page 47
Embryology......Page 51
Congenital hymenal abnormalities......Page 52
Anomalies of the uterus, cervix, and vagina......Page 54
Incidence......Page 55
Transverse vaginal septum......Page 56
Longitudinal vaginal septum......Page 57
Obstructed hemi-vagina with ipsilateral renal agenesis......Page 58
Vaginal agenesis (MUllerian aplasia)......Page 60
Creation of a Functional Vagina......Page 63
Surgical Repair......Page 64
rudimentary uterine horns......Page 66
Unicornuate Uterus......Page 67
References......Page 68
Urologic Issues in the Pediatric and Adolescent Gynecology Patient......Page 73
Evaluation of genitourinary complaints......Page 74
Vulvovaginitis and Vaginal Discharge......Page 78
Urinary tract infection and urinary tract infection type symptoms......Page 79
Sorting out daytime incontinence......Page 83
Summary......Page 85
Review Case 1......Page 86
References......Page 87
Genital Trauma in the Pediatric and Adolescent Female......Page 89
Straddle Injury......Page 90
Vulvar Hematomas......Page 91
Accidental Penetrating Injuries......Page 92
Accidental vaginal insufflation injuries......Page 93
Accidental and Inflicted Burns......Page 94
Coitally Related Vaginal Injuries......Page 95
Female Genital Mutilation/Female Circumcision......Page 96
Effect of Hormones......Page 97
Diagnoses that can be confused with sexual abuse or injury......Page 98
Advocacy......Page 99
References......Page 100
Why is it important to discuss sexuality with adolescent patients?......Page 103
Biologic Factors......Page 104
Early adolescence (11 to 13 years)......Page 105
Late adolescence (17 to 21 years)......Page 107
Same-sex sexual activity and homosexuality......Page 108
Establishing rapport......Page 109
Interview the Adolescent without Accompanying Adults Present......Page 110
Outline the office visit......Page 111
Use written questionnaires for sensitive questions......Page 112
Adolescent Sexuality, Culture, and Religion......Page 113
The Physical Examination......Page 114
Laboratory Tests......Page 117
Summary......Page 118
Adolescent risk-screening tools for providers include:......Page 119
The list of Web sites for parents or guardians of adolescents includes:......Page 120
References......Page 121
Update in Adolescent Contraception......Page 122
Barrier methods......Page 123
Other combined hormonal methods......Page 124
Progestin-only methods......Page 127
Emergency contraception......Page 128
References......Page 129
Pathophysiology......Page 132
Metabolic Syndrome......Page 134
Infertility......Page 135
Diagnostic considerations......Page 136
Hirsutism......Page 137
Role of Luteinizing Hormone/Follicle-Stimulating Hormone Ratio......Page 138
Ultrasound......Page 139
Insulin Testing......Page 140
Lifestyle Modification......Page 141
Bariatric Surgery......Page 142
Hair removal techniques......Page 143
Antiandrogens......Page 144
Abnormal bleeding......Page 145
Metabolic Correction with Insulin-Sensitizing Agents......Page 146
Summary......Page 147
References......Page 148
Bleeding Disorders in Adolescents......Page 156
Menorrhagia......Page 157
Screening for bleeding disorders in adolescents who have menorrhagia......Page 158
Endometriosis......Page 159
Hemostatic management of menorrhagia in adolescents who have bleeding disorders......Page 160
Management of acute severe menorrhagia......Page 161
References......Page 162
The hemostatic system: an overview......Page 166
Thrombophilic conditions......Page 167
Hormonal therapy: an important acquired risk factor for thrombosis......Page 169
Absolute and relative risks for thrombosis......Page 170
Should screening for thrombophilia be performed?......Page 171
First-Line Hormonal Options for Contraception and Noncontraceptive Medical Therapy......Page 172
Emergency contraception......Page 173
Summary......Page 174
References......Page 175
Incidence and pathophysiology......Page 179
Pathophysiology highlights: genetics, epidemiology, inflammatory......Page 180
Management strategies......Page 181
Medical Therapy......Page 182
Summary......Page 184
References......Page 185
The Epidemiology of Anal Human Papillomavirus and Related Neoplasia......Page 188
Acknowledgments......Page 189
Epidemiology of anal intraepithelial neoplasia......Page 190
Screening for anal intraepithelial neoplasia and anal cancer......Page 191
Anal screening algorithms......Page 192
Performing anal cytology......Page 193
Performing a high-resolution anoscopy......Page 194
Treatment modalities......Page 195
Summary......Page 198
References......Page 199