Pediatric gynecology

• Malformations of the genital apparatus: such as pictures of imperforate hymen, hydrocolpus, hydrometrocolpus.
• Abnormalities of the vulva: such as vulvar synechiae in the girl or pictures of frank hypertrophy and asymmetry of the labia minora at puberty, lichen sclerosus of the vulva in childhood.
• Menstrual disorders: such as irregular, heavy, too frequent or sporadic menstruation.
• Dysmenorrhea, painful menstruation or with symptomatology that affects the daily life of young women.
• Contraception.
• Sexeducation and sexually transmitted diseases.
• Infections affecting the genital sphere in childhood and adolescence.

Diagnosis

The assessment and diagnosis of disorders and possible pathologies is carried out by:

• Anamnesis: assessment of the child and adolescent is first of all based on careful and thorough history taking, which is done with parental support in the early stages of life. From age 6 onward, when the child shows cooperation, data collection can take place in a combined manner. In the adolescent, the reference becomes the patient herself; parents intervene when the girl requests it or when she is unable to provide specific indications related to family data.
• Gynecological examination: this is done in the first instance with an assessment of pubertal development, inspection of the external genitalia, and a thorough objective examination of the abdomen and mammary glands.
• If an evaluation of the pelvic organs (uterus and ovaries) is necessary, a noninvasiveultrasound, performed transabdominally, is performed.
• Any sampling of secretions to be performed in depth is done with the use of special micro-catheters that do not generate trauma or any discomfort in the child.

Treatments

In case treatment is needed, all treatment set follows the guidelines provided by the International Federation of Child and Adolescent Gynecology, compiled and endorsed by Gynea, the Swiss Society of Pediatric Gynecology. In particular, the consultation offers:

• Prophylaxis and therapy of dysmenorrhea with prostaglandin inhibitors.
• Hormonal therapies when menstrual rhythm disturbances are related to endocrinological changes.
• Targeted antibiotic/antimycotic therapies in cases of genital system infections in the girl child and adolescent and sexually transmitted diseases with genital localization.

Joint interdisciplinary assessments

Collaborating in the consultation:

• Pediatric endocrinology specialists .
• Pediatric surgical specialists, in the case of malformative pictures or other pictures requiring intervention.
• Gynecologists, in the case of adolescents for whom gynecological ultrasound or uro-gynecological consultations are necessary.
• Radiologists, for performing ultrasound scans or reporting examinations of young patients, and who have appropriate training in the management of specialized pediatric gynecology cases.
• Psychologists and psychotherapists, both hospital-based and field-based, in case of need for specialized support for the emotional aspect.