Polycystic Ovary Syndrome in Adolescents.

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrinologic disorder that is characterized by oligomenorrhea or amenorrhea and signs of hyperandrogenism. The cause of PCOS remains unknown, but the syndrome is associated with insulin resistance that in turn leads to hyperandrogenism. An accurate and prompt diagnosis of PCOS is important to understanding an adolescent's risk.

Enhanced Recovery After Surgery (ERAS) Practices in Minimally Invasive Gynaecologic Surgery: A National Survey.

Objectives: Enhanced recovery after surgery (ERAS) pathways are evidence-based practices that minimize perioperative physiologic stress, reducing postoperative complications and recovery time. This study assessed the Canadian application of, and adherence to, ERAS recommendations during minimally invasive gynaecologic surgery, and identified barriers to ERAS uptake.

Methods: A self-administered cross-sectional survey was distributed to obstetrics and gynaecology residents, fellows, and attendings through 3 national listservs from February 2021 to January 2022.

Retrospective Review of Management of Antenatally Diagnosed Ovarian Cysts at the Hospital for Sick Children.

Introduction: Postnatal management of antenatally diagnosed ovarian cysts is not well-defined. The clinical course, management, and outcomes of patients with antenatally diagnosed ovarian cysts were reviewed.

Methods: Infants <1 year of age with antenatally diagnosed ovarian cyst managed at The Hospital for Sick Children between January 2017 and December 2021 were included.

Case Report: Neonate Presenting with Acute Kidney Injury Secondary to Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome: Long-Term Follow-Up.

Background: Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome describes a spectrum of Mullerian anomalies characterized by uterine didelphys, unilateral obstructed hemivagina, and ipsilateral renal anomalies. We report the case of a neonatal complication secondary to OHVIRA syndrome with long-term follow-up, adding to the collective understanding of this syndrome.

Case Summary: We present a 22-day-old female with an acute kidney injury secondary to post-renal obstruction from a large hydrometrocolpos.

The Tailored Opioid Reduction Strategy (TORS): A Quality Improvement Initiative to Reduce Opioid Prescription Following Hysterectomy.

Objective: To evaluate a tailored opioid reduction strategy (TORS) in minimizing opioid prescriptions for patients undergoing hysterectomy.

Methods: This quality improvement initiative was developed by multiple stakeholders at an academic hospital in a Canadian urban centre. The intervention consisted of a three-pronged approach: (1) patient and provider education, (2) perioperative multimodal analgesia, and (3) a targeted opioid reduction strategy.

Clinical Review: Prepubertal Bleeding.

Background: Prepubertal bleeding is a common presentation in the pediatric office and can be distressing for patients and families. A comprehensive approach to diagnosis and management allows clinicians to identify patients at risk for worrisome pathology and arrange timely care.

Objective: We aimed to review the key features of clinical history, physical exam, and diagnostic workup of a child presenting with prepubertal bleeding.

Management of Acute Genital Ulcers: A Survey of North American Pediatric and Adolescent Gynecology Care Providers.

Introduction: Acute genital ulcers are painful ulcerations of the lower vagina and vulva, with limited data to guide management. We aimed to survey care providers to understand the workup and management of acute genital ulcers across North America.

Methods: A cross-sectional survey was distributed to members of NASPAG.

Case Report: An Uncommon Etiology of Vulvar Irritation and Swelling in an Adolescent Patient.

Introduction: Vulvovaginal concerns are common among adolescent patients. In postmenarchal patients, common etiologies include poor hygiene, contact irritants, and infection.

Case: A 14-year-old transgender male presented with concerns of vulvar irritation and significant labial enlargement.

Screening for Gonococcal and Chlamydial Infections in the Third Trimester.

A retrospective study was conducted at our institution of all patients who delivered between May 2016 and April 2017. A change of practice had been instituted, which involved obstetricians testing for Neisseria gonorrhoeae and Chlamydia trachomatis universally in the first and third trimesters. Medical records were reviewed for N.

Directive clinique n 423 : Interventions chirurgicales et thérapeutiques esthétiques génitales féminines.

Objectif: Fournir aux chirurgiens et autres fournisseurs de soins canadiens qui réalisent des interventions chirurgicales ou thérapeutiques esthétiques génitales féminines, et tout praticien demandeur, des directives fondées sur des données probantes en réponse à l'augmentation des demandes et de la disponibilité des interventions chirurgicales et thérapeutiques vaginales et vulvaires sortant du cadre traditionnel de la reconstruction avec indication médicale.

Population Cible: Les femmes de tous âges qui consultent pour subir une intervention chirurgicale ou thérapeutique esthétique génitale. BéNéFICES, RISQUES ET COûTS: Les professionnels de la santé qui prodiguent des soins aux femmes jouent un rôle important en renseignant les femmes sur leur anatomie et en les aidant à prendre conscience des variations individuelles.

Guideline No. 423: Female Genital Cosmetic Surgery and Procedures.

Objective: To provide Canadian surgeons and other providers who offer female genital cosmetic surgery (FGCS) and procedures, and their referring practitioners, with evidence-based direction in response to increasing requests for, and availability of, vaginal and vulvar surgeries and procedures that fall outside the traditional realm of medically indicated reconstructions.

Target Population: Women of all ages seeking FGCS or procedures.

Benefits, Harms, And Costs: Health care providers play an important role in educating women about their anatomy and helping them appreciate individual variations.

Fertility and Pregnancy Outcomes After Robotic-assisted Laparoscopic Myomectomy in a Canadian Cohort.

Study Objective: Myomectomy is the gold standard treatment for patients with symptomatic fibroids who desire fertility preservation. Given the relatively recent application of robotic surgery in the field of gynecology, there is only a small amount of data describing fertility outcomes after robotic-assisted laparoscopic myomectomy (RALM). The objective of this study was to determine the pregnancy rate in patients trying to conceive after RALM.

Diagnostic Performance of a Sonographic Volume and Solid Vascular Tissue Score (VSVTS) for Preoperative Risk Assessment of Pediatric and Adolescent Adnexal Masses.

Study Objective: To evaluate the diagnostic performance of a Volume and Solid Vascular Tissue Score (VSVTS) for preoperative risk assessment of pediatric and adolescent adnexal masses.

Design: A retrospective cohort study comprised of all female individuals who presented with an adnexal mass that was managed surgically between April 2011 and March 2016.

Setting: The Hospital for Sick Children (Toronto, Ontario, Canada).

Robotic-Assisted Laparoscopic Hysterectomy for Endometrial Hyperplasia or Grade 1 Endometrial Adenocarcinoma: A 10-year, Single-Centre Experience.

Objective: To describe the outcomes of patients undergoing robotic-assisted laparoscopic hysterectomy for grade-1 endometroid endometrial cancer or endometrial hyperplasia at our centre.

Methods: Retrospective chart review was completed for 160 patients who underwent robotic-assisted laparoscopic hysterectomy by 5 general gynaecologists in a tertiary care setting between September 2008 and September 2018. Outcomes collected included operative time, estimated blood loss, length of stay, perioperative complications, readmissions, and recurrences.

Concurrent Prophylactic Mastectomy, Immediate Reconstruction, and Salpingo-Oophorectomy in High-Risk Patients: A Case Series.

Purpose: There are limited data on coordinated breast and gynecological risk-reduction surgery for high-risk patients in Canada. Therefore, this study aims to evaluate the patient demographics, surgical details, and outcomes of prophylactic mastectomy (PM) with immediate reconstruction and bilateral salpingo-oophorectomy (BSO) in high-risk patients.

Methods: We conducted a retrospective chart review at an academic center of patients who concurrently underwent PM with immediate reconstruction and laparoscopic BSO over a 7-year period (March 2010-February 2017) were identified.

Treatment Choices in a National Cohort of Canadian Women With Symptomatic Uterine Fibroids.

Objectives: To describe treatment choices made at the time of enrollment in CAPTURE, a Canadian patient registry for women with symptomatic uterine fibroids (UFs), and to define demographic and clinical characteristics that independently predict these choices.

Methods: Women arranging appointments for UF care were eligible to enrol. At the time of the enrollment visit, women's self-reported treatment histories were noted, along with their clinical characteristics.

The Prevalence of Children and Adolescents at Risk for Avoidant Restrictive Food Intake Disorder in a Pediatric and Adolescent Gynecology Clinic.

Study Objective: The purpose of this study was to determine the prevalence of child and adolescent females at risk for Avoidant Restrictive Food Intake Disorder (ARFID) in a tertiary care pediatric and adolescent gynecology (PAG) clinic.

Design: Cross-sectional study design.

Setting: Tertiary care PAG clinic at the Hospital for Sick Children in Toronto, Ontario, Canada.

Measures to Reduce Perioperative and Intraoperative Blood Loss at Myomectomy: A Survey of Obstetrician-Gynaecologists.

Objective: This study sought to determine current techniques used by Canadian obstetrician-gynaecologists (OB/GYNs) to medically optimize patients undergoing myomectomy during the perioperative and intraoperative periods and to identify gaps in knowledge or barriers to access of blood conservation methods.

Methods: From September to December 2016, a self-administered electronic questionnaire was distributed to 120 Canadian OB/GYNs who perform myomectomies and who practise in either academic, community, or community academic-affiliated hospitals.

Results: A total of 68 of 120 (57%) completed responses were analyzed.