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GYNECOLOGICAL DISORDERS IN
CHILDREN AND ADOLESCENTS
Rukset Attar, MD, PhD
Obstetrics and Gynecology
Department
Newborn Infants
During the first few weeks of life, residual maternal sex
hormones may produce physiologic effects on the
newborn
Labial Adhesions
%1.4
estrogen deficiency and inflammation
applying estrogen cream to the fine thin raphe twice a
day for 2 weeks followed by once daily application for
2 weeks.
parents are asked to repeat the course of treatment in
6-month to 1-year intervals if recurrence occurs.
Imperforate Hymen
Surgical incision
Vulvitis
Diagnosis is made by
inspecting at night with a flashlight to observe worms
exiting the anus
a morning inspection with "Scotch tape" to the anal
region can identify the eggs.
Treatment consists of mebendazole (Vermox) 100 mg
orally once and repeated in 1 week.
It is advised to treat the entire family to prevent reinfection
Lichen Sclerosus
Sexual abuse
Infectious Vulvovaginitis
Hemophilus influenzae, Staphylococcus aureus, group A hemolytic streptococci, and Streptococcus pneumoniae causing
a yellowish to greenish purulent vaginal discharge (S.
pneumoniae infection and group (amoxicillin 40 mg/kg divided
three times a day for 10 days)
Shigella flexneri, an enteric pathogen, can cause a
mucopurulent, sometimes bloody discharge following an episode
of diarrhea in some young girls(trimethoprim (TMP)sulfamethoxazole (Bactrim) 6 to 10 mg/kg/d TMP by mouth,
divided every 12 hours. Treatment may require more than 10 to
14 days of medication.)
Physiologic Discharge
Condyloma Acuminata
in children less than 2 years of age, the mode of
transmission is vertical from mother to child during
childbirth.
After age 2, sexual abuse is a primary concern in
children presenting with condylomatous lesions (in
approximately one third of cases)
treatment
trichloroacetic acid
podophyllin
cryotherapy
CO2 laser vaporization therapy
more recently the advent of imiquimod cream (Aldara), an
immune response modifier supplied in a cream base, has
eased and revolutionized therapy for external genital warts (A
thin layer of cream is applied to the wart(s) at bedtime and left
on for 6 to 10 hours, after which it is washed off. Therapy is
for 3 days a week (i.e., Monday, Wednesday, and Friday) and
continued until the warts are completely gone, or up to 16
week )
Urethral Prolapse
Foreign Bodies
Sexual Abuse
Genital infection with Neisseria gonorrhoeae is
associated with a purulent thick yellow discharge
along with vulvar erythema and edema.
Chlamydia trachomatis may present with
vulvovaginitis, pruritis, and discharge. Infants born to
mothers with chlamydia may carry the organism for
up to 18 months
Diagnosis
History
Physical examination
Vaginoscopy
Specimen collection
Collection of Specimens
Pelvic ultrasound
computed tomography
magnetic resonance imaging (MRI) scan