Experts in Children's Hospital Colorado's Department of Pediatric and Adolescent Gynecology are dedicated to advancing the field to improve the care and lives of all young females with gynecologic conditions. That's why we conduct research to advance care techniques that can be used for our patients and kids anywhere. Watch the gynecology medical education videos below for protocols and research from our experts to help improve the care of your patients.
Specialized fertility preservation and reproductive late effects expertise
In 2019, there were over 1.7 million new cases of cancer, with 10,270 cases occurring among children ages 0 to 14 years of age and 70,000 occurring in adolescents and young adults. With a five-year survival rate of 84%, there are 100,000 annual survivors of reproductive age. Of these survivors, 75% will experience at least one adverse effect, termed late effects of cancer therapy.
In this video, the Director of the Fertility Preservation and Reproductive Late Effects Program, Leslie Appiah, MD, discusses the prevalence of reproductive late effects and female risk stratification based on age and therapy doses. Dr. Appiah also reviews the expert consensus position statements that provide guidance on how providers should care for this population, including informing patients about options for fertility preservation and future reproduction prior to treatment. She reviews the services that the Program provides, such as inpatient and outpatient consults, fertility preservation services and reproductive healthcare, and how to request consultation.
Abnormal uterine bleeding in adolescents
Menstrual bleeding in adolescents can be chaotic. When is it best to reassure, and when is it necessary to evaluate? Although anovulatory cycles are common in the years after menarche, there are established norms and, alternatively, abnormal findings that require further investigation. Uterine bleeding that is coming more often than every three weeks, lasting longer than seven days in a row, or resulting in excessive product use and frequent bleeding through clothes should be evaluated.
In this video, adolescent gynecologist Eliza Buyers, MD, discusses the management of abnormal uterine bleeding (AUB) in adolescent patients. She provides an overview of the physiology and evaluation of AUB, including recommendations on when to consider referring patients to our Spots and Dots Clinic. Dr. Buyers also reviews treatment options, including menstrual suppression, with a focus on key counseling points to help patients and families decide which method is best for them.
Ovarian cysts in children: from neonates to adolescents
Cystic ovarian masses commonly occur in infants, children and adolescents. They may be discovered due to symptoms, during a routine physical exam or incidentally through imaging studies. Historically, these masses were surgically removed, often involving removal of the entire ovary. Over the last decade, however, the management of ovarian masses has shifted toward a more conservative approach with the goal of ovarian preservation.
In this video, Chief of Pediatric and Adolescent Gynecology, Tricia Huguelet, MD, discusses the epidemiology, clinical features and management of ovarian cysts that may occur during the fetal and neonatal periods, and on through adolescence. She also discusses the preferred diagnostic modality and when to consider surgery. In addition, she reviews the potential for ovarian torsion, including signs and symptoms, evaluation and management.
Causes and Treatment of Pelvic Pain in Adolescent Females
Chronic pelvic and abdominal pain can be debilitating for a young girl. Finding the source of this pain in adolescent females and diagnosing the condition can also be particularly challenging.
In this video, Stephen Scott, MD, MPH, emphasizes the fact that pain originates from nerve signaling and uses this understanding to help him identify the source of pain and its cause. Watch the video to learn how Dr. Scott teams up with specialists from urinary and gastrointestinal medicine to develop a holistic approach to identifying and managing chronic pelvic pain in adolescent girls.
Diagnosing and Treating MRKH in Adolescent Girls
Affecting approximately one in every 4,500 newborn girls, Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome can be challenging to treat both medically and psychologically, due to the potential loss of fertility. In this video, Veronica Alaniz, MD, MPH, talks about the types of Müllerian agenesis associated with MRKH. This includes the process for diagnosis and considerations for work-up, evaluation and treatment, such as support and counseling.
Pediatric Vaginoscopy and Hysteroscopy Procedures
Gynecological examination of the prepubertal girl can be challenging. In the office setting, the examination should be limited to external inspection only; speculum exams should not be performed in pediatric patients. Procedures such as vaginoscopy can be used for the diagnosis of gynecologic conditions in prepubertal girls.
In this video, pediatric and adolescent gynecologist Veronica Alaniz, MD, discusses the indications, proper technique and risks of vaginoscopy and hysteroscopy. Vaginoscopy is a diagnostic procedure that can be used to evaluate the inside of the vagina and is recommended for girls who are too young for a speculum exam or cannot tolerate one. Hysteroscopy is a procedure to evaluate and manage issues of the uterine cavity and is typically only performed in adolescents when indicated. Hysteroscopy is performed in the operating room under general anesthesia. When indicated, both vaginoscopy and hysteroscopy procedures can be performed by a pediatric and adolescent gynecologist at Children’s Hospital Colorado.