Journal Of Pediatric And Adolescent Gynecology[JOURNAL]
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200 papers
A Novel TP63 Mutation in a Patient with Premature Ovarian Insufficiency Type 21: Clinical Phenotype and Diagnostic Challenges.
Cardoso BF, Mazeda ML, Gomes VR … +1 more , Brandão C
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42379264 · Publisher ↗
BACKGROUND: Primary ovarian insufficiency (POI) is a rare cause of primary amenorrhea in adolescents. We report a case of POI Type 21 caused by a TP63 pathogenic variant. CASE PRESENTATION: An otherwise healthy 15-year-o...
BACKGROUND: Primary ovarian insufficiency (POI) is a rare cause of primary amenorrhea in adolescents. We report a case of POI Type 21 caused by a TP63 pathogenic variant. CASE PRESENTATION: An otherwise healthy 15-year-old girl presented with primary amenorrhea and absent thelarche. Investigations confirmed hypergonadotropic hypogonadism (46, XX karyotype). Pelvic MRI showed a hypoplastic uterus (14 × 9 × 10mm) and indistinguishable ovaries. Genetic testing identified a pathogenic TP63 variant. Estrogen replacement therapy via escalating transdermal estradiol doses resulted in thelarche (Tanner stage 4) and remarkable uterine growth (35 × 18mm). CONCLUSIONS: Identifying the genetic etiology of POI is crucial for clinical management and family planning. TP63 variants represent a rare but significant cause of non-syndromic POI, requiring long-term multidisciplinary care and genetic counseling.
From PCOS to Polyendocrine Metabolic Ovarian Syndrome (PMOS): Implications for Adolescent Gynecologic Care.
Ng NBH, Cree MG, Pena AS … +3 more , Witchel SF, Khomami MB, Teede HJ
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42372905 · Publisher ↗
Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly polycystic ovary syndrome (PCOS), affects approximately 6.3% of adolescents worldwide. Diagnosis in this population remains challenging due to overlap with normal...
Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly polycystic ovary syndrome (PCOS), affects approximately 6.3% of adolescents worldwide. Diagnosis in this population remains challenging due to overlap with normal pubertal physiology. Currently international guideline adolescent-specific criteria require both oligo-anovulation and hyperandrogenism, while excluding ovarian criteria, due to poor specificity during early post-menarchal years. For decades, the term "PCOS" has remained scientifically inaccurate (there are no increased abnormal cysts) and conceptually restrictive, centering on ovarian morphology, while failing to reflect the broader endocrine, metabolic, psychological and dermatological and reproductive dimensions of the condition. Moreover, evidence shows that the name PCOS was perceived by adolescents, their parents, and healthcare professionals as, confusing, and stigmatizing, contributing to diagnostic delay and communication barriers. A rigorous global consensus process involving 56 organizations, multiple stages and over 22000 survey responses, and iterative Delphi rounds led to the new name Polyendocrine Metabolic Ovarian Syndrome (PMOS). This new terminology more accurately reflects underlying pathophysiology by removing focus from incorrect ovarian cyst-based terminology and acknowledging endocrine and metabolic underpinnings. Importantly, extensive implementation is underway including changing ICD codes and reclassifying the disorder beyond the ovary, - vital to broaden research, education and care. For clinicians caring for adolescents, the new name, classification and implementation strategy, offers a valuable opportunity to reframe diagnosis and management.Meaningful adolescent partnership will be critical to ensure that this renaming and conceptual shift translates into improved understanding and more comprehensive patient centered-care.
GLP-1 Receptor Agonists in Adolescents: Emerging Endocrine, Reproductive, and Psychosocial Concerns.
Haider MA, Javed H
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42364709 · Publisher ↗
OBJECTIVE: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed to adolescents for obesity and type 2 diabetes mellitus (T2DM), with growing interest in extending their use to conditions such...
OBJECTIVE: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed to adolescents for obesity and type 2 diabetes mellitus (T2DM), with growing interest in extending their use to conditions such as polyendocrine metabolic ovarian syndrome (PMOS, formerly known as polycystic ovary syndrome or PCOS). However, adolescence represents the critical window for peak bone mass acquisition, and the implications of pharmacologic weight loss during this developmental period have received limited attention. Furthermore, this commentary addresses potential concerns related to eating disorder risk and future reproductive outcomes in this population. METHODS: This commentary examines the emerging concerns regarding bone health, reproductive safety, eating disorder risk and endocrine development when GLP-1 RAs are used in adolescent populations. RESULTS: Adult studies demonstrate improvements in weight loss, insulin resistance, and menstrual regularity with GLP-1 RA therapy. In adolescents with obesity, clinical trials of liraglutide and semaglutide show significant weight reduction without short-term effects on growth or pubertal development. However, adolescence represents a critical period for peak bone mass acquisition, and rapid pharmacologic weight loss may theoretically impair bone mineral accrual. Evidence from adult populations suggests modest reductions in bone mineral density associated with weight loss, while structured exercise may mitigate these effects. GLP-1 RAs are not recommended during pregnancy, and no data exist on reproductive outcomes following adolescent exposure. Additionally, the potent appetite-suppressing effects of these agents raise concerns about potential misuse or exacerbation of eating disorders in adolescents, a population uniquely vulnerable to body image pressures. CONCLUSIONS: GLP-1 RAs represent a promising adjunct therapy for adolescents with obesity, T2DM, and PMOS, but long-term skeletal, reproductive, psychological, and endocrine outcomes remain uncertain. Careful patient selection, bone health monitoring, incorporation of resistance exercise, contraceptive counseling, and screening for disordered eating may be essential when these therapies are considered in adolescent populations.
Breaking Barriers: Assessing the Educational and Reproductive Health Implications of Period Poverty Among Secondary School Girls.
Alawode-Atoki RA, Esan DT
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42314904 · Publisher ↗
PURPOSE: Period poverty remains a critical yet underrecognized barrier to adolescent girls' education, health, and psychosocial well-being. This review synthesizes current evidence on the educational, reproductive health...
PURPOSE: Period poverty remains a critical yet underrecognized barrier to adolescent girls' education, health, and psychosocial well-being. This review synthesizes current evidence on the educational, reproductive health, and psychosocial implications of period poverty among secondary school girls. METHODS: A narrative literature review was conducted using peer-reviewed articles and institutional reports published between 2015 and 2025. Studies examining menstrual hygiene management, access to menstrual products, school participation, reproductive health outcomes, and psychosocial impacts among adolescent girls were included. Thematic analysis was used to synthesize findings across settings. RESULTS: Period poverty was consistently associated with school absenteeism, reduced classroom engagement, and poorer academic performance. Inadequate access to menstrual products and water, sanitation, and hygiene (WASH) facilities contributed to increased risks of reproductive and urinary tract infections. Psychosocial consequences included shame, anxiety, low self-esteem, and depressive symptoms, exacerbated by stigma and cultural taboos. Structural determinants, including poverty, weak school infrastructure, limited parental education, and policy gaps were key drivers. School-based interventions, community engagement, and health system involvement emerged as effective mitigation strategies. CONCLUSIONS: Period poverty significantly undermines adolescents' educational attainment, health, and dignity. Multisectoral strategies integrating education, health services, WASH infrastructure, and community-based interventions are essential to promote menstrual equity and adolescent well-being. Addressing period poverty is fundamental to advancing gender equity and achieving global development goals.
Transcutaneous Tibial Nerve Stimulation for Adolescent Dysmenorrhea: Beyond the Sham-Methodological and Mechanistic Considerations.
Qiu C, Zhao M
J Pediatr Adolesc Gynecol · 2026 May · PMID 42303475 · Publisher ↗
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Clinical Spectrum, Morphometrics, and Management of Perineal Cleft in Female Children.
Fahmy MAB, Jafarli I, Elkhouly A … +1 more , Othman DSAA
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42302920 · Publisher ↗
BACKGROUND: Perineal cleft (PC), also known as perineal groove, is a rare congenital anomaly of the female perineum characterized by a midline mucosal defect of variable extent. Despite its distinctive morphology, the co...
BACKGROUND: Perineal cleft (PC), also known as perineal groove, is a rare congenital anomaly of the female perineum characterized by a midline mucosal defect of variable extent. Despite its distinctive morphology, the condition remains underrecognized and may be associated with other anogenital malformations. AIM: To determine the prevalence, clinical spectrum, associated anomalies, morphometric characteristics, and management outcomes of perineal cleft in female neonates, infants, and young children. PATIENTS AND METHODS: Between 2018 and 2025, a prospective cross-sectional evaluation of the genital and perineal regions was conducted in 4.100 female patients aged 1 day to 12 years. Suspected cases of perineal cleft underwent detailed clinical assessment for associated anomalies. Anogenital distance (AGD) was measured using a digital caliper, and selected patients underwent examination under general anesthesia. Histopathological evaluation was performed in 35 cases. RESULTS: Perineal cleft was diagnosed in 52 patients (≈1.27% of the cohort). Complete defects extending to the anal verge were identified in 19 cases, while the remainder exhibited incomplete forms. Associated findings included vulvar edema, hymenal tags or polyps, and anorectal anomalies, particularly abnormal anal positioning. AGD was significantly shorter in affected patients compared with controls (P < 0.001). Histopathology demonstrated a non-keratinized columnar epithelial lining in most biopsied lesions. Surgical intervention was required in 15 patients, primarily those with associated anorectal malformations, whereas the majority of isolated defects resolved spontaneously with conservative management. CONCLUSION: Perineal cleft is an uncommon congenital anomaly frequently coexists with hymenal lesions and anorectal anomalies. Most cases are asymptomatic and undergo spontaneous epithelialization during early childhood, supporting a conservative management approach. Increased awareness is essential to avoid misdiagnosis and unnecessary invasive procedures.
Abdominoperineal reconstruction of the high vagina in cloaca and urogenital sinus - A report in 25 girls.
Sen S, Kurian JJ, Kotaiah TM … +1 more , Arunachalam P
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42302919 · Publisher ↗
AIM: To evaluate the management of high vagina in cloaca and non-congenital adrenal hyperplasia (non-CAH) urogenital sinus (UGS) using a staged, need-based, non-traditional surgical approach. MATERIALS AND METHODS: A ret...
AIM: To evaluate the management of high vagina in cloaca and non-congenital adrenal hyperplasia (non-CAH) urogenital sinus (UGS) using a staged, need-based, non-traditional surgical approach. MATERIALS AND METHODS: A retrospective review (2010-2024) was conducted on 25 girls undergoing reconstruction of a high vagina. Management consisted of delayed, need-based vaginoplasty rather than total correction in infancy, using a top-down abdominal approach instead of Total Urogenital Mobilisation (TUM) or Posterior Sagittal Anorectovaginourethroplasty (PSARVUP). Clinical presentation, associated anomalies, operative details, urinary and genital (excluding reproductive) outcomes were analysed. RESULTS: Before vaginoplasty, 13 patients had prior anorectal repair and 10 had urinary tract surgery. Vaginal pathology included 7 urocolpos and 11 haematocolpos, including 5 with genitourinary outflow obstruction following failed surgery on the UGS. Vaginoplasty was performed at a mean age of 10 years (range 0-20); emergent for symptomatic obstruction or elective in asymptomatic cases. An abdominal approach allowed separation of the vagina from the UGS without dissection of the urethro-vaginal confluence. The mobilised vagina reached the perineum directly in six patients and 19 required bowel interposition. Symptom relief was achieved in all cases. Two patients developed superficial introital stenosis. Sixteen patients void spontaneously; nine perform clean intermittent catheterisation via a Mitrofanoff channel for pre-existing urinary dysfunction. CONCLUSION: Management of cloaca and non-CAH UGS with high vagina should be staged, need-based, and appropriately timed. Puberty may unmask high vaginal anomalies that could be compromised by early total correction. Avoiding dissection of the UGS and vaginal confluence appears to preserve volitional voiding.
Vaginal dermoid cyst: A case report.
Rahmon D, Richardson R, Isaacson E … +4 more , Fenner D, Rosen M, McCracken K, Dendrinos ML
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42297205 · Publisher ↗
BACKGROUND: Vaginal dermoid cysts are exceedingly rare benign germ cell tumors, which present unique diagnostic and surgical challenges. CASE: A 17-year-old nulligravid patient presented with acute-on-chronic pelvic pain...
BACKGROUND: Vaginal dermoid cysts are exceedingly rare benign germ cell tumors, which present unique diagnostic and surgical challenges. CASE: A 17-year-old nulligravid patient presented with acute-on-chronic pelvic pain, dyspareunia, and difficulty with tampon insertion. Imaging with transvaginal ultrasound and CT of abdomen and pelvis suggested a fat-containing pelvic mass presumed to be intraperitoneal. Two laparoscopies were performed, the second with excision of a benign corpus luteum. Subsequent pelvic exam and pelvic MRI allowed for improved localization and characterization of the mass, and transvaginal excision later confirmed a vaginal dermoid cyst. The postoperative course was complicated by vaginal hematoma requiring reoperation. CONCLUSION: Although rare, vaginal dermoid cysts should be included in the differential diagnosis of atypical cystic pelvic masses. Accurate preoperative localization with physical exam and advanced imaging is essential to guide appropriate management and avoid unnecessary surgery.
Premenstrual Disorders in Adolescents: An Updated Review.
Rome ES, Kaznoch D, Issac VE
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42285394 · Publisher ↗
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are prevalent among adolescents and young adults worldwide and can substantially impair emotional well-being, daily functioning, and family life. Thi...
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are prevalent among adolescents and young adults worldwide and can substantially impair emotional well-being, daily functioning, and family life. This review summarizes current definitions of premenstrual disorders (PMDs); examines validated retrospective and prospective diagnostic tools; and reviews epidemiology, pathophysiology, and both pharmacologic and nonpharmacologic management strategies. It also highlights clinical strategies to improve recognition, patient and family education, and advocacy to reduce stigma and advance care.
Response to the letter to the editor regarding: "Eating attitudes, sleep quality, and self-esteem in adolescents diagnosed with polycystic ovary syndrome".
Altıkardesler OK, Dural O, Evruke I … +3 more , Ulusoy HE, Aksakal MZT, Bas F
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42285393 · Publisher ↗
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Adolescent Experiences with Procedural Sedation for Intrauterine Device Placement: A Pilot Study.
Bryant E, Stancil S, Priebe AM … +2 more , Nos A, Lawson A
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42285392 · Publisher ↗
PURPOSE: This study examines adolescent experiences with intrauterine device (IUD) insertion under conscious sedation. METHODS: We conducted a prospective pilot study of 11-21-year-olds who chose conscious sedation for t...
PURPOSE: This study examines adolescent experiences with intrauterine device (IUD) insertion under conscious sedation. METHODS: We conducted a prospective pilot study of 11-21-year-olds who chose conscious sedation for their IUD insertion. Participants completed pre-procedure surveys (e.g., demographics, anticipated pain, reproductive history) and post-procedure surveys (e.g., pain during insertion and overall experience). Providers completed a survey on the day of IUD insertion with sedation type, complications, and reason for sedation. RESULTS: In 16 youth (16.1 ± 1.8 years), 14 received moderate sedation (intravenous midazolam and fentanyl) and 2 received light sedation (nitrous oxide). The most reported "worst part" was procedural cramps (n=5, 31%). The "best part" was sedation effects (n=7, 44%). All patients who received light sedation remembered the insertion compared to 2 of 14 (14%) patients who received moderate sedation. Patients reported an average satisfaction score of 83 on a 100-point visual analogue scale, with no difference between sedation types. DISCUSSION: Adolescents were highly satisfied with procedural sedation for IUD insertion. Fewer participants remembered the procedure when they received moderate compared to light sedation. IMPLICATIONS AND CONTRIBUTIONS: IUDs are effective as reversible contraception and menstrual management. The pelvic exam and pain may discourage use of the IUD, but sedation offers an alternate experience. Examining patient experiences will help clinicians counsel future patients on their anticipated experience and provides evidence-based rationale for modification and expansion of this service.
Menstrual Problems in Adolescents with Juvenile Idiopathic Arthritis: A Comparison with Healthy Controls.
Torun ŞE, Akman AÖ, Kubilay İ … +4 more , Kaşıkçı M, Özçelik E, Yoğun SN, Çelikel Acar B
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42285391 · Publisher ↗
OBJECTIVE: Although menstrual disorders are frequent in adolescent girls, limited data exist regarding their occurrence and characteristics in patients with juvenile idiopathic arthritis (JIA). This study aimed to determ...
OBJECTIVE: Although menstrual disorders are frequent in adolescent girls, limited data exist regarding their occurrence and characteristics in patients with juvenile idiopathic arthritis (JIA). This study aimed to determine the frequency of menstrual problems, premenstrual syndrome (PMS), and dysmenorrhea-related coping skills in adolescents with JIA, and to examine their potential associations with disease-related parameters, treatment, and quality of life (QoL). METHODS: This cross-sectional study included 51 adolescents with JIA and 56 age- and BMI-matched healthy controls (HC) recruited from pediatric rheumatology and adolescent health clinics. Menstrual characteristics, PMS, and dysmenorrhea were assessed using structured questionnaires, the Premenstrual Syndrome Scale, and the Adolescent Dysmenorrhea Self-Care Scale (ADSCS). QoL was measured by the Pediatric Quality of Life Inventory (PedsQL). Disease-related data, treatment history, and laboratory findings were obtained from medical records. RESULTS: The age at menarche was significantly later in the JIA group than in HC (13 vs. 12 years, p = 0.001). Dysmenorrhea was common in both groups (74.5% vs. 89.2%, p = 0.046) but coping scores were lower in the JIA group (79 vs. 99, p = 0.004). PMS frequency was lower in JIA (39.2% vs. 57.1%, p = 0.064), and total PMS scores were significantly reduced (102 vs. 118.5, p = 0.005). No associations were found between menstrual problems and disease activity, steroid dose, or methotrexat/biologic use. CONCLUSION: Adolescents with JIA experience frequent menstrual problems and delayed menarche. During routine pediatric rheumatology visits, adolescent girls' menstrual history should be systematically assessed, and those with significant or troubling gynecological problems should be referred appropriately.
Changes of a congenital nevus of the vulva after the beginning of puberty.
Stefanaki C, Chardalias L, Alexopoulos A
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42269815 · Publisher ↗
Little is known about the clinical course of genital nevi and particularly the congenital ones. We present the case of girl with a congenital genital nevus that after the beginning of puberty doubled its size. The nevus...
Little is known about the clinical course of genital nevi and particularly the congenital ones. We present the case of girl with a congenital genital nevus that after the beginning of puberty doubled its size. The nevus was excised and histopathology revealed a dysplastic melanocytic nevus with mild and rare severe atypia. Our case illustrates the changes observed in a congenital nevus of the genitalia after puberty, when the genitalia change due to hormonal effects, which occasionally may cause unnecessary anxiety. Moreover, our case underlines the ambiguous histological features of genital nevi in children.
Beyond Size: Sonographic Trajectory as a Tool for Surveillance and Surgical Timing in Neonatal Ovarian Cysts - A Retrospective Cohort Study.
Dreznik Y, Goldstein Y, Konen O … +4 more , Eisner M, Almog A, Paran M, Kravarusic D
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42269814 · Publisher ↗
BACKGROUND: Neonatal ovarian cysts are the most common abdominal masses in female infants and are frequently detected prenatally. Although most are benign and hormonally driven due to maternal estrogen, optimal postnatal...
BACKGROUND: Neonatal ovarian cysts are the most common abdominal masses in female infants and are frequently detected prenatally. Although most are benign and hormonally driven due to maternal estrogen, optimal postnatal management-particularly regarding surgical timing and surveillance intensity-remains controversial. Current decision-making relies primarily on cyst size and morphology, with limited emphasis on longitudinal sonographic behavior. OBJECTIVE: To evaluate clinical characteristics, management strategies, and outcomes of neonatal ovarian cysts, with particular focus on sonographic trajectory during follow-up and its potential role in guiding surveillance and surgical timing. METHODS: A retrospective cohort study was conducted including female infants diagnosed with neonatal ovarian cysts between 2015 and 2025 at a tertiary pediatric medical center. Patients were managed conservatively with serial ultrasound follow-up or surgically, based on clinical judgment and imaging findings. Sonographic trajectories were classified as regressive, progressive, or stable non-regressive according to relative changes in cyst size over time. Clinical and imaging outcomes were analyzed and compared between management groups. RESULTS: Forty-seven infants were included, with prenatal diagnosis documented in 80.9%. Seventeen patients (36.2%) underwent surgical intervention, while 30 (63.8%) were managed conservatively. Surgically managed cysts had significantly larger cysts on initial postnatal ultrasound compared with conservatively managed patients (median 60.0 mm vs 27.5 mm, p = 0.001). Regressive sonographic trajectories predominated among conservatively managed patients (21/30, 70.0%), whereas progressive or stable non-regressive patterns were more common in the surgical group (16/17, 94.1%; p < 0.001). Ovarian autoamputation was identified in 5/17 (29.4%) surgically treated patients, all of whom demonstrated a non-regressive trajectory prior to intervention. CONCLUSIONS: Most neonatal ovarian cysts in this cohort were successfully managed conservatively. Beyond absolute cyst size, longitudinal sonographic trajectory provides additional clinically relevant information that may support individualized surveillance and surgical decision-making.
Examining Structural and Social Drivers of Human Papillomavirus Vaccination Rates Across Clinical Settings for Youth.
Narkhede A, Vidwans A, Nelson R … +2 more , Coughlin E, Sanders LJ
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42269813 · Publisher ↗
STUDY OBJECTIVE: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of cervical, anal, and oropharyngeal cancers. Despite effectiveness in cancer prevent...
STUDY OBJECTIVE: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of cervical, anal, and oropharyngeal cancers. Despite effectiveness in cancer prevention, HPV vaccination rates remain suboptimal. This study examines HPV vaccination initiation and completion among adolescents and young adults across clinic types, demographics, and social determinants of health (SDOH) to identify barriers and inform interventions. METHODS: We conducted a retrospective cross-sectional analysis using electronic health record data from adolescent medicine, pediatric infectious diseases, internal medicine-pediatrics, and family medicine clinics in the University of South Florida health system and an affiliated community youth sexual health clinic. The study included 456 patients aged 16-24 seen from January to March 2025. HPV vaccination initiation and completion were assessed across clinic types, demographics, and SDOH using descriptive, univariate, bivariate, and multivariate analyses. RESULTS: Overall, 390 patients initiated and 354 completed the HPV vaccination series across 20 clinics. Initiation rates were comparable across clinic types, but completion differed significantly by setting. Completion was independently associated with having insurance, an established primary care provider, completion of other routine vaccines, comorbidities, and female gender. Clinic type was not an independent predictor after adjusting for patient-level factors. CONCLUSION: HPV vaccination rates in this cohort exceeded national averages, with strong initiation but lower completion, particularly among uninsured patients and those without primary care access. These findings underscore that vaccination outcomes are shaped more by patients' social and structural circumstances than by clinic setting alone, highlighting the importance of contextualizing completion rates accordingly. Targeted system-level interventions are needed to improve series completion and reduce future HPV-related cancer disparities.
Abdominopelvic Pain and Overlapping Pain Conditions in Patients with Mayer-Rokitansky-Küster-Hauser Syndrome.
Lowe SJ, Vincent SJ, Sumida MF … +1 more , Dietrich JE
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42269812 · Publisher ↗
STUDY OBJECTIVE: Our objectives were to estimate the prevalence of abdominopelvic pain (AP) in patients with Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH), compare the prevalence of AP in patients with anatomic variatio...
STUDY OBJECTIVE: Our objectives were to estimate the prevalence of abdominopelvic pain (AP) in patients with Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH), compare the prevalence of AP in patients with anatomic variations and extragenital anomalies in MRKH, and estimate the prevalence of overlapping pain conditions (OPC) in patients with MRKH. METHODS: Retrospective cohort study of MRKH patients seen at an academic center (2014 - 2024), identified using ICD-10 codes for uterine agenesis (UA) or vaginal agenesis (VA). Inclusion criteria included a confirmed diagnosis of MRKH. Patients with 46,XY karyotypes were excluded. Descriptive statistics were performed. Chi-square analyses were used for categorical variables and two-tailed student's t tests were used for continuous variables to compare features of MRKH patients, including presence/absence of uterine remnants (UR). Multivariate logistic regression was performed to further evaluate associations with AP. RESULTS: 117 patients were identified and subcategorized by UR status (UR n=63, no UR n=54), and MRKH type (Type 1 n=65, Type 2 n=52). Overall, 36.8% of patients (n=43) reported persistent AP and 20.5% of patients (n=24) cyclic AP. UR were associated with persistent (p = 0.008) and cyclic AP (p = 0.001). There was no association between MRKH type and persistent (p = 0.732) or cyclic AP (p = 0.282). 23.9% of (n=28) patients were treated for ≥1 OPC, with migraine headache (n=21) and IBS (n=8) being most common. CONCLUSIONS: Given the burden of persistent and cyclic AP among MRKH patients, careful and timely evaluation for pain is warranted. Management should focus on clinical presentation over imaging findings.
Development of a Surgical Simulation Model for Management of Complete Vaginal Stenosis: A Feasibility Study.
Monestime GM, Ajjarapu AS, Bhora V … +2 more , Bawiskar A, Dietrich JE
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42259443 · Publisher ↗
STUDY OBJECTIVE: Opportunities for vaginal surgery education vary across pediatric and adolescent gynecology (PAG) and OB/GYN training programs, with limited exposure to vaginal reconstructive techniques. Consequently, m...
STUDY OBJECTIVE: Opportunities for vaginal surgery education vary across pediatric and adolescent gynecology (PAG) and OB/GYN training programs, with limited exposure to vaginal reconstructive techniques. Consequently, many trainees apply these reconstructive techniques for the first time in the operating room. To address this gap in surgical education, we performed a feasibility study wherein the development and implementation of the Complete Vaginal Stenosis simulation model is described. We describe the model's use in highlighting the Z-plasty technique for surgical management of complete vaginal stenosis. METHODS: We created the model in collaboration with a local undergraduate engineering group. The model was developed in an iterative fashion over 2 simulation workshops hosted at the North American Society for Pediatric and Adolescent Gynecology Annual Clinical and Research meeting in 2024 and 2025. RESULTS: A total of 70 participants completed the post-simulation feedback survey. In 2025, 71% of respondents reported that the simulation workshop duration was "just right", compared with 62% in 2024. Mean 10-point scale ratings of the hands-on experience with the simulation model were similar across years (9.4 in 2024 and 9.3 in 2025). All participants reported they would participate in the Z-plasty simulation again. CONCLUSION: In the next phase of implementation, inclusion of our simulation model into surgical curricula may allow for longitudinal assessment of trainees. It is important that gynecologic surgeons are trained to master vaginal reconstructive techniques prior to real-life clinical application in the operating room. Use of our Complete Vaginal Stenosis model may support procedural readiness and improve reproductive health outcomes.
Healthcare Burden of Trial-and-Error Contraceptive Prescribing in Adolescents.
Monestime GM, Norman AC, Cua M … +2 more , Pennington KA, Hakim J
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42252075 · Publisher ↗
STUDY OBJECTIVE: The current approach to contraception care is largely trial-and-error based. Approximately 40% of patients discontinue their chosen contraceptive method within the first year of use due to unfavorable si...
STUDY OBJECTIVE: The current approach to contraception care is largely trial-and-error based. Approximately 40% of patients discontinue their chosen contraceptive method within the first year of use due to unfavorable side effects. We aimed to: 1) describe healthcare burden experienced by adolescents during contraceptive trials ("trial burden"), and 2) identify sociodemographic factors that modify trial burden experienced by adolescents and clinicians. METHODS: We conducted a retrospective chart review of 100 adolescents initiating contraception at a tertiary care pediatric and adolescent gynecology clinic from 2021-2023. Sociodemographic data were collected. The primary outcome was contraceptive trial burden, defined as number of contraceptive trials, number of contraception-related outpatient visits, and duration of each trial. Secondary outcomes included prescription of secondary medication for side effect management, emergency room (ER) utilization, and unintended pregnancy. Pearson correlation and ANOVA tests were performed. RESULTS: Mean age at contraception initiation was 15.4 ± 1.7 years. Adolescents required 2.2 ± 1.3 contraceptive trials over 19.3 ± 21.3 months, spanning over 6.3 ± 4.1 outpatient clinic visits prior to initiation of a final contraceptive method. Thirty-one percent required secondary medication for side effect management. Five adolescents presented to the ER for contraception-related complications. Four adolescents experienced unintended pregnancy during their contraceptive trials. Spanish-speaking adolescents attended more contraception-related outpatient visits and were more likely to require ER care. CONCLUSION: Trial-and-error contraceptive prescribing in adolescents is associated with significant and avoidable healthcare utilization. Study findings highlight inefficiencies in current contraceptive prescribing practices and the need for clinical tools that will assist with contraception selection, thereby streamlining contraception care and reducing healthcare burden for patients and providers.
Early Life Factors Associated with Pubertal Development in Girls: A Cohort Study.
Zhou Y, Li L, Wang Y … +5 more , Wu X, Yang Q, Xiao R, Yan G, Liu Q
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42250694 · Publisher ↗
BACKGROUND: Increasing evidence suggests that pubertal development may be influenced by early-life maternal exposures. However, the associations between maternal characteristics across the perinatal period and pubertal d...
BACKGROUND: Increasing evidence suggests that pubertal development may be influenced by early-life maternal exposures. However, the associations between maternal characteristics across the perinatal period and pubertal development in daughters remain incompletely understood. This study aimed to examine these associations in a prospective cohort of school-aged girls. METHODS: A total of 733 girls were recruited from four primary schools in Chongqing, China. Participants were aged 7.19-12.80 years at baseline in December 2014 and were followed up every 6 months until June 2022. Pubertal development was assessed using four indicators: breast development, pubic hair development, axillary hair development, and menarche. Information on maternal characteristics before, during, and after pregnancy was collected. Cox proportional hazards regression models were used to evaluate associations between early-life maternal factors and the onset of pubertal development. RESULTS: In multivariable Cox models, girls whose mothers did not report using tocolytic agents during pregnancy had earlier breast development than those whose mothers reported tocolytic agent use (HR = 1.497, 95% CI: 1.024-2.188). Maternal disease during pregnancy was associated with earlier axillary hair development (HR = 1.332, 95% CI: 1.018-1.743). Daughters of mothers aged ≥35 years at delivery had earlier axillary hair development than those whose mothers were aged 20-25 years (HR = 1.471, 95% CI: 1.075-2.012). Compared with exclusive breastfeeding during the first 6 months, mixed feeding was associated with earlier menarche (HR = 1.328, 95% CI: 1.010-1.745). CONCLUSIONS: Maternal and perinatal characteristics were associated with the timing of specific pubertal milestones in girls, highlighting the potential importance of early-life health management.
Gynecologic Concerns for Children and Adolescents with Vascular Anomalies.
Ujvary AN, Gupta D, Debiec KE
J Pediatr Adolesc Gynecol · 2026 Jun · PMID 42250693 · Publisher ↗
Vascular anomalies (VA) are disorders of capillary, venous, arterial, and lymphatic endothelium and include vascular tumors and vascular malformations. VA are often diagnosed in infancy or childhood and may involve the v...
Vascular anomalies (VA) are disorders of capillary, venous, arterial, and lymphatic endothelium and include vascular tumors and vascular malformations. VA are often diagnosed in infancy or childhood and may involve the vulva, vagina, perineum, rectovaginal septum, uterus, or bladder. Individuals with VA can have gynecologic issues like anatomical distortion, pain, prepubertal bleeding, abnormal uterine bleeding or special considerations for contraception, menstrual management or pregnancy related to their vascular anomaly. An understanding of vascular anomaly nomenclature, classification, underlying genetic factors, and current diagnostic and therapeutic options is important for pediatric and adolescent gynecologic providers to support accurate diagnosis, facilitate multidisciplinary coordination, and promote optimal patient care.
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