Contraception in Adolescents.

The adolescent care provider has a unique opportunity to provide young patients with appropriate counseling about sexual health and prevention of pregnancy and sexually transmitted infections. To provide high-quality sexual and reproductive health care for the adolescent, providers must be familiar with the breadth of contraceptive options and their characteristics. The purpose of this review is to discuss recent developments in contraception and to review commonly used contraceptive methods as they apply to adolescents.

Incidence of Abnormal Findings During Pelvic Examinations in Women Aged 21-35 Years.

To describe the incidence of abnormal gynecologic examination findings in asymptomatic compared with symptomatic patients during preventive visits, we conducted a retrospective study of 1,121 visits for patients between the ages of 21 and 35 years from January 2017 to March 2017. Only 1.2% (95% CI, 0.

Levels of Gynecologic Care: A Task Force Consensus Statement.

Systems of care have been established for obstetrics, trauma, and neonatology. An American College of Obstetricians and Gynecologists Presidential Task Force was established to develop a care system for gynecologic surgery. A group of experts who represent diverse perspectives in gynecologic practice proposed definitions of levels of gynecologic care using the Delphi method.

Surgical considerations and challenges in the pediatric and adolescent gynecologic patient.

It is important for practitioners to recognize that there are special considerations when performing gynecologic surgery in a pediatric or adolescent patient. A provider must be familiar with differences in anatomy, physiology, surgical technique, and psychosocial concerns. This can be challenging for a provider who does not routinely operate on patients in this population.

Gynecologic and Obstetric Consequences of Obesity in Adolescent Girls.

In the past few decades, there has been an overwhelming increase in childhood and adolescent obesity worldwide. Besides the well recognized cardiometabolic complications and other physical conditions associated with obesity, during adolescence, it causes psychological and social distress in a period of life that is already sensitive for a girl. This in turn increases their risk of low self-esteem and depression.

Management of Large Ovarian Neoplasms in Pediatric and Adolescent Females.

The overwhelming majority of ovarian cysts in pediatric and adolescent girls are physiologic; however, large simple and complex ovarian lesions often require surgical intervention due to the increased risk of neoplasia. In this review article, we discuss the preoperative evaluation and intraoperative management of large ovarian neoplasms. We review the current literature regarding long term ovarian function and fertility, rates of recurrence and residual disease, and novel surgical approaches.

Development of a web-based laparoscopic technical skills assessment and testing instrument: a pilot study.

Objective: Current surgical training programs rely heavily on subjective assessments to measure operative proficiency, despite heavy emphasis on standardized testing as a means to rank scholastic ability. A compact laparoscopic simulator was developed with the intention to create a technical skill evaluation system that resembles standardized testing to provide the user with real-time percentile scores in a variety of skill metrics. The calculation of percentiles is only accurate if the pool of scores resembles a specific distribution (e.

Self-attempted labioplasty with elastic bands resulting in severe necrosis.

Background: Labial hypertrophy is protuberant labial tissue extending beyond the labia majora. Self-perception of poor cosmetic appearance is common in young patients and not necessarily pathologic. Labioplasty is indicated for patients with persistent symptoms including entrapment and painful intercourse.

Single-site laparoscopic management of a large adnexal mass.

Introduction: Single-site laparoscopy is gaining acceptance in many surgical fields including gynecology. The purpose of this report is to demonstrate the technique and outcome for removing a large adnexal mass through a single site.

Case Description: A 41-y-old female was referred to gynecology oncology for increased abdominal girth for 3 mo.

Large epidermal cyst of the clitoris: a novel diagnostic approach to assist in surgical removal.

Background: Epidermal cysts of the clitoris are uncommon and usually associated with previous trauma. Surgical removal is the preferred treatment with close attention to preserve sensation and vascular supply. The use of an alternative coil during Magnetic Resonance (MR) imaging to visualize the anatomy may improve surgical management and outcomes.

Update on key topics in adolescent gynecology.

AM:STARs, the Adolescent Medicine State of the Art Reviews series published by the American Academy of Pediatrics, devoted its April 2012 issue to the topic of Adolescent Gynecology. Developed in conjunction with the North American Society for Pediatric and Adolescent Gynecology (NASPAG), the issue consists of twelve articles, written mostly by members of NASPAG. As editors of the issue, we present in this review for the Journal of Pediatric and Adolescent Gynecology (JPAG) a synopsis of the most salient concepts presented in those 12 articles.

Klippel-Trenaunay syndrome complicated by ascites and vaginal lymphatic drainage in adolescence: a case report.

Background: Klippel-Trenaunay syndrome is a rare disease characterized by capillary malformationsand soft tissue and bony hypertrophy and atypical varicosities. Management of this syndrome is focused primarily on treatment of the complications that arise from these malformations. Ascites and lymphedema are two of the more common complications in these patients.

Adolescent gynecology: special considerations for special patients.

Developments in the field of adolescent gynecology highlight the specific expertise and care required by this population. Given the ability to shape their future health choices, adolescents are a critical target for preventative health care. The approach to the evaluation and management of this unique population rests not only on the practitioner's adept ability to recognize the unique clinical challenges that may occur, but also rests on his/her understanding of these problems.

Intrauterine contraception in adolescents and young women: a descriptive study of use, side effects, and compliance.

Objective: Describe characteristics, compliance, efficacy, and side effect profile of adolescents and young women who use intrauterine contraception (IC).

Study Design: Retrospective chart review of adolescent and young women who had IC devices placed over a 3-year period. Comparative statistics between devices and population characteristics were performed using the Fisher exact and the t test.

Expanding the SOAP Note to SOAPS (With S for Safety): A New Era in Real-time Safety Education.

The challenges inherent in medical education are multiple, including recognition of different learning styles among students, incorporation of the Accreditation Council for Graduate Medical Education competencies and outcomes measurement into the curriculum, and compliance with mandated duty hours along with a heightened awareness of patient safety required by our regulatory institutions. With the requirement that safety become an explicit part of the residency curriculum across all specialties, educators are charged with innovative ways of achieving this goal. The following commentary addresses this need and suggests an innovative approach to the traditional daily rounds' SOAP (subjective, objective, assessment, and plan) note to incorporate a second S for safety.

Follow-up compliance of adolescents with cervical dysplasia in an inner-city population.

Study Objective: Adolescent compliance with cytologic and histologic cervical abnormalities is poor. Recent changes in abnormal cytology follow-up and colposcopy indications in young women may delay the diagnosis of cervical dysplasia. The objective of our study was to determine the compliance with follow up.

The care of adolescents by obstetrician-gynecologists: a first look.

Study Objective: To determine whether obstetrician-gynecologists who typically care for adolescent patients, what this care entails, and the adequacy of training opportunities in adolescent health care.

Design: A questionnaire designed to elicit information regarding practice patterns of obstetrician-gynecologists mailed to the American College of Obstetricians and Gynecologists Collaborative Ambulatory Practice Network.

Participants: Obstetrician-gynecologists whose patient populations included girls under the age of 18.

Update in adolescent contraception.

Pregnancy rates in the United States seem to have stabilized in the past decade but continue to be higher than those in other industrialized nations. Although abstinence and barrier methods are available and efficient in preventing pregnancy, a comprehensive approach is a better choice when counseling patients on available options. The new approach to old contraceptive methods provides new alternatives to adolescents seeking safe and reliable methods.

Adolescent gynecology.

Given new developments in the field of adolescent reproductive health, this review focuses on highlighting new guidelines and practice patterns in evaluation and management of adolescent gynecologic problems. First, understanding the proper techniques for the initial examination is key to establishing a long-term relationship with this age group. Reservations about the first gynecologic examination are common, and the practitioner's goal is foremost to make the patient as comfortable as possible.

The physical examination in pediatric and adolescent patients.

The initial evaluation and examination of both the pediatric and adolescent patients provides the opportunity for the clinician to establish a relationship that will ensure the successful outcome of the visit. In the younger age group, cooperation of the child before performing an examination should be the focus at the first encounter. This cooperation will enable proper positioning and a systematic approach to examination and documentation of findings.

Massive edema of the ovary: a case report and review of the pertinent literature.

Background: Massive edema of the ovary is a rare entity affecting mainly young women. It is often misdiagnosed for a malignancy, posing the young patient at risk for over-treatment with resultant loss of hormonal function and fertility.

Case: A 13-year-old premenarchal girl presented with a large solid pelvic mass after recurrent episodes of self-limited abdominal pain.