Pediatric and Adolescent Gynecology Services

We see pediatric and adolescent patients across the spectrum of gynecology, for conditions as common as heavy or irregular menstrual cycles, to more complex conditions such as rare abnormalities of the reproductive organs. Whether dealing with common or complex issues, our first priority is to make our patients feel safe and comfortable.

Services we offer

The coordinated care we provide means that you have direct access to necessary medical and surgical services, and the most comprehensive care possible. We provide routine gynecologic care in our Pediatric and Adolescent Gynecology Clinic, with locations at Anschutz Medical Campus in Aurora, at our South Campus in Highlands Ranch and at our North Campus in Broomfield. We also routinely collaborate with our colleagues at Children’s Hospital Colorado to provide more complex gynecologic care, when needed. As one of the facets of providing excellent care, we also offer many educational opportunities. By educating girls and their families, we help remove some of the stigmas that may be associated with gynecology. We believe that creating a safe environment for children and their parents to ask questions is the first step toward understanding any gynecological condition. Some of our educational and medical services include:

• Preventive reproductive health guidance, counseling and screening
• Total gynecologic care throughout the reproductive lifespan, with faculty who can transition adolescents to our adult practice, maintaining the same close patient-physician relationship
• Age-appropriate evaluation and treatment for gynecologic conditions including heavy and irregular menstrual bleeding, painful menstrual cycles and endometriosis, vulvovaginal conditions and genital trauma
• Surgical treatment for conditions such as ovarian torsion, ovarian cysts, vulvar and vaginal conditions, undiagnosed pelvic pain and congenital anomalies (irregularities that exist at birth)
• Surgical consultation and multidisciplinary care with surgical specialists in pediatric urology, pediatric surgery, and colorectal surgery
• Specialized pediatric and adolescent gynecology clinics for patients with reproductive health concerns in cancer and blood disorders, fertility preservation, special care, pain management, endocrinology for children with disorders of sexual development (DSD) and polycystic ovarian syndrome

Pediatric and adolescent gynecology tests and procedures

Discussions between your child and their doctor are always private, but sometimes in pediatric gynecology, we deal with especially sensitive issues. Not only does the nature of our work require a special level of trust and sensitivity, we also work with children, which requires a higher level of empathy and understanding. We’ve taken all these factors into account when designing our pediatric gynecology tests and procedures.

Tests

The goal of performing tests and exams is to reach an accurate and timely diagnosis. In addition, we strive to minimize the number of tests and exams to reduce anxiety and minimize invasiveness. If you or your daughter suspects something may be wrong, we always start with a discussion to understand the symptoms and a thorough review of her medical history. Once we understand the symptoms and medical history, we may continue with some of the following tests:

• Physical exam: A simple visual inspection that consists of looking only at the external genital area. A physical exam allows us to diagnose more common conditions such as labial adhesions or vulvovaginitis.
• Blood test: A blood test helps us identify irregularities such as an elevated white blood count or decreased red blood cell count, which may be a sign of infection or anemia.
• Urine test: This allows us to test for urinary tract infections, which can be cause of pelvic pain – a sign of numerous other gynecological conditions.
• Sexually transmitted infection (STI) test: If we discover in our initial discussion that the patient is sexually active, we use STI tests to identify any infection they may have.
• Imaging tests: We perform imaging tests using equipment such as ultrasounds and magnetic resonance imaging (MRI). These tests provide non-invasive, accurate methods of diagnosing conditions that affect the internal reproductive system. An ultrasound, which uses high-frequency sound waves, can produce detailed images of internal structures by simply moving a probe along the outside of the abdomen or pelvis. An MRI uses magnets to produce detailed images of the body’s organs and structures. During an MRI, the patient must lay down and remain still as it scans the body. With both tests, we routinely collaborate with radiologists who work with these machines in high volumes and have proven expertise in interpreting the detailed images. Our radiology team also has the advantage of being at a regional referral center where they see a large number of both common and rare conditions, which makes them extremely important in helping us accurately diagnose these conditions.

Procedures

As with testing, we have designed our procedures to be minimally invasive, which means we use the best technology available to see things inside the body without having to perform major surgery. In addition to using imaging devices such as ultrasounds and MRIs, we also use very small cameras to see inside the body without having to make large incisions.

• Laparoscopy: This minimally invasive procedure allows surgeons to look inside the body at the abdominal and pelvic organs using a small camera. While under general anesthesia, which keeps your child asleep during the procedure, our surgeon makes a small incision and uses the camera to get a detailed, live view of the internal organs. Diagnostic laparoscopy allows us to make definitive diagnoses of serious conditions without making a large incision.

  Laparoscopy is also used to perform surgery using the same small camera to help guide the surgeon. The camera and small tools are insert through very small incisions that are about 5mm long. As with diagnostic laparoscopy, we use general anesthesia to keep your child asleep during surgery, so they will not feel any pain and will not have any memory of the procedure. Using this minimally invasive procedure, the surgeon can perform surgical treatments for a range of conditions while minimizing scarring, reducing the chance of infection and decreasing recovery time. We commonly use laparoscopic surgery to treat gynecological conditions such as ovarian torsion, endometriosis, acute and chronic pelvic pain and congenital anomalies of the reproductive tract. In most cases, these are outpatient surgeries that do not require an overnight stay.

• Laparoscopic cystectomy: A type of laparoscopic surgery, this minimally invasive procedure is used to remove a cyst, which is a fluid-filled sac. In pediatric and adolescent gynecology, we typically deal with cysts located within the ovaries or adjacent to the fallopian tube, which are called ovarian cysts and paratubal cysts, respectively. For a laparoscopic cystectomy, the surgeon makes three very small incisions that are about 5mm in length. The surgeon then places a very small camera through one incision and places two specialized tools through the other incisions. They carefully remove the cyst using the tools and then take the cyst out of the body. By using the laparoscopic approach, our surgeons can take every precaution to maximize future reproductive potential by preserving normal ovarian tissue.

Pediatric and adolescent gynecology procedure outcomes

As one of the largest pediatric and adolescent gynecology teams in the nation, we are a regional referral center with high patient volumes in medical and surgical care for kids and teens with gynecological conditions.

The large number of patients that we see provides us with a depth of experience that leads to outcomes that are among the best in the country.