Journal of pediatric and adolescent gynecology最新文献_第3页

Pediatric Breast Pathologies: 5-Year Experience and Proposal for a Risk-Based Management Algorithm. 儿童乳腺病理：5年经验和基于风险的管理算法建议。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-02 DOI: 10.1016/j.jpag.2026.01.287

Sefa Sağ, Yagmur Sonmez, Esma Karadeniz Gungormez, Furkan Adem Canbaz, Gonca Gercel, Dilek Yavuzer, Elif Yasar, David Terence Thomas

Study objective: Breast complaints in children are uncommon, and standardized management guidelines are lacking. Adult-based protocols are often extrapolated to pediatric patients despite differences due to breast development and different disease behavior. We aimed to review our institutional experience and propose a practical, evidence-informed diagnostic and management algorithm.

Methods: A retrospective review was conducted of all female pediatric patients who presented with breast-related complaints to a tertiary pediatric surgery clinic between June 2020 and June 2025. Demographic and clinical characteristics, imaging findings, treatments, and histopathological results were analyzed.

Results: A total of 293 female patients (mean age 14.2 ± 3.5 years; range 1-18) were evaluated. The most common presenting complaints were pain (47.4%) and palpable mass (41.9%). Ultrasonography was performed in 96.9% of patients, and breast masses were detected in 68.6%. During a mean follow-up of 31.4 ± 3.8 months, 81% of masses remained stable or regressed, and only 3.9% required surgery. Histopathology revealed fibroadenoma (55.6%), benign phyllodes tumor (22.2%), pseudoangiomatous stromal hyperplasia (11.1%), and accessory nipple tissue (11.1%).

Conclusion: No malignancy was detected in any patients who underwent biopsy or surgery in the present study. Most pediatric breast lesions are benign and can be managed conservatively with periodic clinical and ultrasonographic follow-up. Magnetic resonance imaging appears to be a valuable adjunct in selected cases with indeterminate imaging findings. A stepwise, risk-stratified algorithm was developed to guide the evaluation and management of breast masses in children. This approach may minimize unnecessary interventions while ensuring safe surveillance of pediatric breast lesions.

研究目的：儿童乳房主诉并不常见，缺乏标准化的治疗指南。尽管由于乳房发育和不同的疾病行为而存在差异，但以成人为基础的方案经常被外推到儿科患者。我们旨在回顾我们的机构经验，并提出一个实用的、循证的诊断和管理算法。方法：对2020年6月至2025年6月期间在某三级儿科外科诊所就诊的所有与乳房相关的女性儿科患者进行回顾性研究。分析了人口统计学和临床特征、影像学表现、治疗方法和组织病理学结果。结果：共纳入293例女性患者，平均年龄14.2±3.5岁，范围1 ~ 18岁。最常见的主诉是疼痛（47.4%）和可触及的肿块（41.9%）。96.9%的患者行超声检查，68.6%的患者检出乳腺肿块。在平均31.4±3.8个月的随访中，81%的肿块保持稳定或消退，只有3.9%的肿块需要手术。组织病理学显示纤维腺瘤（55.6%），良性叶状瘤（22.2%），假性血管瘤间质增生（11.1%），副乳头组织（11.1%）。结论：本研究中所有接受活检或手术的患者均未发现恶性肿瘤。大多数儿童乳腺病变是良性的，可以通过定期临床和超声随访保守处理。磁共振成像似乎是一个有价值的辅助选择病例不确定的影像学表现。开发了一种逐步的风险分层算法来指导儿童乳腺肿块的评估和管理。这种方法可以最大限度地减少不必要的干预，同时确保儿童乳腺病变的安全监测。

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引用次数: 0

FSH Receptor Variant: An Unusual Cause of Secondary Amenorrhea FSH受体变异：继发性闭经的不寻常原因。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2025-06-06 DOI: 10.1016/j.jpag.2025.06.002

Oluwatosin O. Cooper (Tosin) MD, MPH , Elisabeth H. Quint MD , Yolanda R. Smith MD , Melina L. Dendrinos MD

Introduction

Secondary amenorrhea with high Follicle Stimulating Hormone (FSH) levels and low estradiol is typically diagnosed as primary ovarian insufficiency (POI) in individuals under the age of 40. Low anti-mullerian hormone (AMH) levels support the diagnosis of POI, but normal AMH levels warrant additional evaluation.

Case Presentation

A 19-year-old female with menarche at age 12 experienced secondary amenorrhea at age 14.5. Initial evaluation showed elevated gonadotropins and low estradiol, which were confirmed on repeat testing. Normal karyotype, no FMR1 repeat expansion, negative autoimmune markers, and normal AMH levels were found. Genetic testing revealed two Follicle Stimulating Hormone Receptor (FSHR) gene variants with high suspicion of pathogenicity.

Discussion

Pathogenic variants in the FSHR gene are an uncommon cause of secondary amenorrhea. Atypical POI cases with a normal AMH level should be evaluated with a genetic consultation.

导语：继发性闭经伴高促卵泡激素（FSH）水平和低雌二醇通常诊断为原发性卵巢功能不全（POI）在40岁以下的个体。低抗苗勒管激素（AMH）水平支持POI的诊断，但正常的AMH水平需要额外的评估。病例介绍：一名19岁女性，12岁初潮，14.5岁继发性闭经。初步评估显示促性腺激素升高和雌二醇低，这在重复测试中得到证实。核型正常，无FMR1重复扩增，自身免疫标记阴性，AMH水平正常。基因检测显示两种促卵泡激素受体（FSHR）基因变异具有高致病性。讨论：FSHR基因的致病性变异是继发性闭经的罕见原因。AMH水平正常的非典型POI病例应通过遗传咨询进行评估。

引用次数: 0

Laparoscopic Management of Tubercular Pyosalpinx Torsion in an Adolescent Girl: A Case Report 腹腔镜下治疗青春期女孩输卵管结核性扭转1例。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2025-10-09 DOI: 10.1016/j.jpag.2025.10.002

Avantika Gupta MBBS, MS, MRCOG, Satish Choudhury MBBS, MS, DNB, Vandana Kattimani MBBS, Deepika Mangani MBBS

Female genital tuberculosis (FGTB) is a form of extrapulmonary tuberculosis that predominantly affects women of reproductive age and is a significant cause of infertility in TB-endemic countries such as India. Tubercular pyosalpinx is a rare presentation of FGTB. Even more uncommon is its complication by isolated tubal torsion, which may mimic other causes of acute abdomen, making early diagnosis challenging.

We report the case of a 15-year-old girl who presented with acute lower abdominal pain and vomiting. She had a 2-month history of low-grade evening fever. Clinical evaluation and ultrasound findings suggested pyosalpinx or hematosalpinx with normal ovarian morphology, raising suspicion of isolated tubal torsion. Diagnostic laparoscopy revealed a torsed, distended fallopian tube filled with purulent material and multiple peritoneal tubercles. The tube was excised using a glove-made improvised endobag to prevent intra-abdominal spillage. Histopathology confirmed tubercular salpingitis with caseous necrosis, and GeneXpert was positive for Mycobacterium tuberculosis. The patient was started on standard anti-tubercular therapy and had an uneventful recovery.

This case underscores the importance of considering tuberculosis as an etiology in adolescent girls presenting with pyosalpinx, especially in TB-endemic regions. It also highlights the value of safe laparoscopic management with innovative surgical techniques in resource-limited settings. Early diagnosis, surgical intervention, and timely initiation of anti-tubercular therapy are crucial for effective management and preservation of reproductive health.

女性生殖器结核病（FGTB）是一种肺外结核，主要影响育龄妇女，在印度等结核病流行国家是导致不孕症的重要原因。结节性脓输卵管炎是FGTB的罕见表现。更罕见的并发症是孤立的输卵管扭转，这可能类似于其他急腹症的原因，使早期诊断具有挑战性。我们报告的情况下，一个15岁的女孩谁提出急性下腹痛和呕吐。她有两个月的低烧史。临床及超声检查提示卵巢形态正常的脓输卵管或血输卵管，怀疑为孤立性输卵管扭转。诊断性腹腔镜检查显示输卵管扭曲、膨胀，充满化脓性物质和多个腹膜结节。使用手套制作的临时内袋切除管，以防止腹腔内溢出。组织病理学证实结核性输卵管炎伴干酪样坏死，GeneXpert检测结核分枝杆菌阳性。患者开始接受标准的抗结核治疗，并顺利康复。本病例强调了将结核作为一种病因在出现脓输卵管炎的青春期女孩中考虑的重要性，特别是在结核病流行地区。它还强调了安全的腹腔镜管理与创新的外科技术在资源有限的设置的价值。早期诊断、手术干预和及时开始抗结核治疗对于有效管理和维护生殖健康至关重要。

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引用次数: 0

Multi-Site Pain During Menstruation in Adolescents is Associated With Impaired Functioning Across Various Domains: A Cross-Sectional Observational Study 青少年月经期间的多部位疼痛与各领域功能受损有关：一项横断面观察研究。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2025-10-16 DOI: 10.1016/j.jpag.2025.10.009

Laura C. Seidman BS , Laura A. Payne PhD

Study Objective

To evaluate multi-site pain (i.e., number of painful body regions) during menstruation in a sample of adolescents, and to assess relationships between multi-site pain during menstruation and other menstrual cycle, pain, and psychosocial factors.

Methods

Participants in this cross-sectional observational study included 141 girls ages 13-19 years with varying levels of menstrual pain. Participants indicated on a body map the areas where they usually experience pain when menstruating. Participants also completed a set of validated self-report questionnaires. Menstruation-associated multi-site pain was calculated as the total number of body regions reported (out of 21). Partial correlations controlling for baseline menstrual pain intensity were conducted between menstruation-associated multi-site pain and other variables of interest.

Results

The average number of body regions reported was 2.8 (SD = 1.5; min = 0; max = 8). Menstruation-associated multi-site pain was significantly positively correlated with number of pre-menstrual syndrome symptoms, non-menstrual multi-site body pain, pain interference over the prior week, fatigue, sleep disturbance, somatization, and multisensory sensitivity. Menstruation-associated multi-site pain was not significantly correlated with age, age at menarche, gynecologic age, menstrual pain interference, and non-menstrual body pain intensity.

Conclusion

Pain during menstruation in adolescents is not limited to the abdominal and pelvic regions, and many girls experience pain in numerous body locations during their periods. The associations between menstruation-associated multi-site pain and other pain and psychosocial measures provide preliminary evidence for the existence of a sub-group of adolescents who may be at increased risk for future pain problems.

研究目的：评估青少年月经期间的多部位疼痛（即身体疼痛区域的数量），并评估月经期间多部位疼痛与其他月经周期、疼痛和社会心理因素之间的关系。方法：这项横断面观察性研究的参与者包括141名年龄在13-19岁之间的女孩，她们有不同程度的月经疼痛。参与者在一张身体地图上标出她们经期通常感到疼痛的部位。参与者还完成了一套有效的自我报告问卷。月经相关的多部位疼痛计算为报告的身体区域总数（共21个）。在月经相关的多部位疼痛和其他感兴趣的变量之间进行了控制基线月经疼痛强度的部分相关。结果：报告的身体区域数平均为2.8个（SD=1.5; min=0; max=8）。经期相关多部位疼痛与经前综合征症状、非经期多部位身体疼痛、前一周疼痛干扰、疲劳、睡眠障碍、躯体化和多感觉敏感性显著正相关。经期相关多部位疼痛与年龄、初潮年龄、妇科年龄、经期疼痛干扰、非经期身体疼痛强度无显著相关。结论：青少年经期疼痛并不局限于腹部和骨盆区域，许多女孩在经期的许多身体部位都会感到疼痛。经期相关的多部位疼痛与其他疼痛和社会心理测量之间的关联为存在一个青少年亚群提供了初步证据，该亚群可能会增加未来疼痛问题的风险。

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引用次数: 0

A Scoping Review of Barriers to Accessing Abortions among Adolescents in the United States 对美国青少年堕胎障碍的范围审查。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2025-10-10 DOI: 10.1016/j.jpag.2025.10.003

Julie Maslowsky PhD , Naomi Harada Thyden PhD, MPH , Renee Odom-Konja MPH , Catherine Gimbrone MPH , Joanna Paul MPH, MSW , Eleanor Esbrook MD , Rosie Hanneke MLS , Laura D. Lindberg PhD

Study Objective

Even before the Dobbs Supreme Court decision, minors experienced a wide variety of barriers to abortion care in the United States, including legal, financial, cultural, transportation, and misinformation barriers as well as pressure from parents and partners. This scoping review summarizes the literature on barriers to abortion among minors in the United States prior to the Dobbs decision.

Methods

We conducted a database search to identify original research in the United States published between 2007 and 2022. We included quantitative and qualitative empirical articles and assessed their quality. We created categories for the barriers to abortion among minors identified in the articles. We screened 7584 records and included 70 articles in the scoping review. We charted study aims, study designs, data sources, analytic samples, and results.

Results

The articles explored factors related to abortion access and identified several categories of barriers to abortion among minors. These included legal barriers (41 articles found them to be a barrier), financial barriers (14 articles), cultural barriers (13 articles), transportation barriers (12 articles), pressure from parents (11 articles), misinformation (8 articles), and pressure from a partner (8 articles). Legal barriers, including laws that require minors to inform or get permission from an adult guardian, were the most commonly identified barrier.

Conclusion

These findings suggest that minors need policy and interpersonal support to overcome general and age-specific barriers to abortion care. Future research should examine if and how barriers for minors have intensified post-Dobbs, informing targeted policy responses.

研究目的：即使在多布斯最高法院判决之前，未成年人在美国经历了各种各样的堕胎护理障碍，包括法律，经济，文化，交通和错误信息障碍以及来自父母和伴侣的压力。本综述总结了多布斯案判决前美国未成年人堕胎障碍的文献。方法：我们进行了数据库检索，以确定2007年至2022年在美国发表的原创研究。我们纳入了定量和定性的实证文章，并评估了它们的质量。我们对文章中确定的未成年人堕胎障碍进行了分类。我们筛选了7584条记录，并将70篇文章纳入范围综述。我们绘制了研究目的、研究设计、数据来源、分析样本和结果的图表。结果：本文探讨了影响未成年人堕胎的因素，并确定了未成年人堕胎的几类障碍。这些障碍包括法律障碍（41篇文章认为它们是障碍）、经济障碍（14篇文章）、文化障碍（13篇文章）、交通障碍（12篇文章）、来自父母的压力（11篇文章）、错误信息（8篇文章）和来自伴侣的压力（8篇文章）。法律障碍，包括要求未成年人告知或获得成年监护人许可的法律，是最常见的障碍。结论：这些研究结果表明，未成年人需要政策和人际支持来克服一般和特定年龄的堕胎护理障碍。未来的研究应该检查未成年人的障碍是否以及如何在多布斯事件后加剧，为有针对性的政策反应提供信息。

{"title":"A Scoping Review of Barriers to Accessing Abortions among Adolescents in the United States","authors":"Julie Maslowsky PhD , Naomi Harada Thyden PhD, MPH , Renee Odom-Konja MPH , Catherine Gimbrone MPH , Joanna Paul MPH, MSW , Eleanor Esbrook MD , Rosie Hanneke MLS , Laura D. Lindberg PhD","doi":"10.1016/j.jpag.2025.10.003","DOIUrl":"10.1016/j.jpag.2025.10.003","url":null,"abstract":"<div><h3>Study Objective</h3><div>Even before the <em>Dobbs</em> Supreme Court decision, minors experienced a wide variety of barriers to abortion care in the United States, including legal, financial, cultural, transportation, and misinformation barriers as well as pressure from parents and partners. This scoping review summarizes the literature on barriers to abortion among minors in the United States prior to the <em>Dobbs</em> decision.</div></div><div><h3>Methods</h3><div>We conducted a database search to identify original research in the United States published between 2007 and 2022. We included quantitative and qualitative empirical articles and assessed their quality. We created categories for the barriers to abortion among minors identified in the articles. We screened 7584 records and included 70 articles in the scoping review. We charted study aims, study designs, data sources, analytic samples, and results.</div></div><div><h3>Results</h3><div>The articles explored factors related to abortion access and identified several categories of barriers to abortion among minors. These included legal barriers (41 articles found them to be a barrier), financial barriers (14 articles), cultural barriers (13 articles), transportation barriers (12 articles), pressure from parents (11 articles), misinformation (8 articles), and pressure from a partner (8 articles). Legal barriers, including laws that require minors to inform or get permission from an adult guardian, were the most commonly identified barrier.</div></div><div><h3>Conclusion</h3><div>These findings suggest that minors need policy and interpersonal support to overcome general and age-specific barriers to abortion care. Future research should examine if and how barriers for minors have intensified post-<em>Dobbs</em>, informing targeted policy responses.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 4-16"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Focal Adenomyosis in a 17-Year-Old Patient: A Case Report 17岁患者局灶性脑卒中1例报告

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2026-02-03 DOI: 10.1016/j.jpag.2025.10.007

Maja Banović MD, PhD , Dina Gržan MD , Vladimir Banović MD, PhD

引用次数: 0

Authors’ Response to “Responding to Adolescents’ Emotional Needs in Abortion: The Importance of Empathy-Based Counseling and Flexible Choice” 作者对“应对青少年堕胎中的情感需求：移情咨询和灵活选择的重要性”的回应

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2026-02-03 DOI: 10.1016/j.jpag.2025.08.004

Laura Kirkpatrick MD

引用次数: 0

Postpartum Contraception Use among Adolescent Mothers 青少年母亲产后避孕措施的使用。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2025-10-27 DOI: 10.1016/j.jpag.2025.10.011

Julie Maslowsky PhD , Eleanor Esbrook MD , Renee Odom-Konja MPH , Haley Stritzel PhD , Catherine Gimbrone MPH , Dorothy Mandell PhD

Study Objective

To describe patterns of postpartum contraception use among primiparous and multiparous adolescent mothers.

Methods

Cross-sectional data came from the Pregnancy Risk Assessment Monitoring System Phase 7 (2012-2015). The analytic sample included postpartum respondents ages 15-19 in 40 US states (N = 5535). Exposures included age, race, parity, intimate partner violence, psychosocial stressors, prenatal care utilization, postpartum home health visits, and insurance type. The primary outcome was postpartum use of effective contraception. The secondary outcome was reasons for not using postpartum contraception.

Results

Adolescents who attended postpartum check-ups (AOR = 2.12; 95% CI 1.58-2.84) or received home health visits (AOR = 1.37; 95% CI 1.06-1.77) were more likely to use effective contraception postpartum, whereas those experiencing more stressors were less likely (AOR = 0.93; 95% CI: 0.86-1.00). Non-Hispanic Black adolescents were less likely to use effective contraception (AOR = 0.69; 95% CI 0.50-0.94) compared to non-Hispanic White adolescents. Among those who did not use contraception postpartum, having a postpartum home health visit was associated with lower odds of endorsing contraceptive side effects (AOR = 0.33; 95% CI 0.18-0.60) or not wishing to use contraception (AOR = 0.43; 95% CI 0.22-0.86) as reasons for nonuse.

Conclusion

Access to postpartum care via home health and postpartum clinic visits was associated with significantly higher likelihood of using effective contraception. However, disparities persisted among non-Hispanic Black adolescents and those experiencing high levels of psychosocial stress. For postpartum adolescents who do not desire a subsequent birth, increasing their ability to obtain effective contraceptives can be achieved through increased access to postpartum care, particularly for underserved populations.

研究目的：描述初产和多产青少年母亲产后避孕的使用模式。方法：横断面数据来自妊娠风险评估监测系统第7期（2012-2015）。分析样本包括美国40个州15-19岁的产后受访者（N= 5535）。暴露因素包括年龄、种族、胎次、亲密伴侣暴力、心理社会压力源、产前护理利用、产后家庭健康访问和保险类型。主要结局是产后有效避孕的使用情况。次要结果是未使用产后避孕措施的原因。结果：参加产后检查（AOR=2.12; 95% CI: 1.58-2.84）或接受家庭健康访问（AOR=1.37; 95% CI: 1.06-1.77）的青少年更有可能在产后使用有效的避孕措施，而经历更多压力源的青少年更不可能（AOR=0.93; 95% CI: 0.86-1.00）。与非西班牙裔白人青少年相比，非西班牙裔黑人青少年较少使用有效避孕措施（AOR=0.69; 95% CI 0.50-0.94）。在那些产后没有使用避孕措施的妇女中，产后家庭健康访问与赞同避孕副作用（AOR=0.33; 95% CI 0.18-0.60）或不希望使用避孕措施（AOR=0.43; 95% CI 0.22-0.86）作为不使用原因的几率较低相关。结论：通过家庭保健和产后门诊就诊获得产后护理与使用有效避孕措施的可能性显著增加相关。然而，在非西班牙裔黑人青少年和那些经历高水平社会心理压力的青少年中，差异仍然存在。对于不希望再生育的产后青少年，可以通过增加获得产后护理的机会来提高他们获得有效避孕药具的能力，特别是对服务不足的人群。

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引用次数: 0

Improving Minimally Invasive Surgical Approaches to Large Adnexal Masses in Pediatric Gynecology: Combining Mini-Laparotomy With Single Port Laparoscopy 改进小儿妇科大附件肿物的微创手术入路：小剖腹与单口腹腔镜相结合。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2025-09-26 DOI: 10.1016/j.jpag.2025.09.012

Megan F. Sumida MD , Olivia K. Winfrey MD, MPH , Julie Hakim MD , Jennifer E. Dietrich MD, MSc

In pediatric populations large ovarian cysts are often benign, and minimally invasive approaches are preferred to minimize perioperative pain and recovery, allow for same day discharge, and improve incision cosmesis. Ovarian preservation is also prioritized and cystectomy is preferred over oophorectomy. While tactile sensation and dexterity are improved in mini laparotomy cases, there are limitations with visualization that are improved with laparoscopy. We describe a technique that employs both diagnostic laparoscopy and mini laparotomy using the GelPOINT Mini™ Advanced Access Platform for single site laparoscopy in pediatric patients. This case series includes cysts ranging 7-24 cm with benign preoperative risk stratification, in patients aged 3-16 years, who underwent successful same-day, ovarian-sparing surgery with the benefits of both open and laparoscopic procedures.

在儿科人群中，较大的卵巢囊肿通常是良性的，微创方法可以最大限度地减少围手术期疼痛和恢复，允许当天出院，并改善切口美容。卵巢保存也是优先考虑的，膀胱切除术优于卵巢切除术。虽然在小型剖腹手术病例中触觉和灵活性得到了改善，但腹腔镜手术改善了视觉上的局限性。我们描述了一种使用GelPOINT mini™高级访问平台进行儿科患者单部位腹腔镜检查的诊断腹腔镜和迷你剖腹手术技术。本病例系列包括7-24厘米的囊肿，术前良性风险分层，患者年龄3至16岁，接受了成功的当天卵巢保留手术，开放和腹腔镜手术均有好处。

引用次数: 0

Nonsedated Intrauterine Device Experiences Among Transgender and Cisgender Adolescents and Young Adults in the Outpatient Setting 门诊跨性别、顺性别青少年和年轻人使用非镇静宫内节育器的经验。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 Epub Date: 2025-09-05 DOI: 10.1016/j.jpag.2025.08.007

Liz Abernathey MD, MS , Morgan E. Ryan MS , Carly E. Milliren MPH , Kym Ahrens MD, MPH , Amy D. DiVasta MD, MMSc , Sarah Pitts MD , Michelle Escovedo MD , Sofya Maslyanskaya MD , Sarah A. Golub MD, MPH

Study Objective

This study compares the demographic characteristics and experiences of three different groups of adolescent and young adults (AYAs) seeking nonsedated intrauterine device (IUD) insertion in the outpatient setting: (1) cisgender individuals, (2) transgender and gender diverse (TGD) individuals receiving gender-affirming testosterone therapy, and (3) TGD individuals not receiving gender-affirming testosterone therapy.

Methods

This retrospective cohort study included AYAs age 13-21 years seeking IUD insertion. Data were obtained from the electronic health record via a pre-existing, multi-institutional shared quality improvement collaborative. The patient population was characterized by descriptive statistics; inferential statistics compared procedural complications, outcomes, and patient-reported side effects. Unadjusted Kaplan–Meier and Cox proportional-hazard modeling assessed continuation rates.

Results

Of the 683 participants attempting IUD insertion, 623 were cisgender individuals, 18 were TGD individuals on gender-affirming testosterone, and 42 were TGD individuals not on testosterone. There was no difference in insertion indication (P = .25). TGD patients on testosterone were more likely to have experienced a procedural adverse event (17%; P = .04), and to have reported pain beyond expectation (P = .003), although insertional success did not differ significantly between groups (P = .22).

Conclusion

TGD AYAs had similar reasons as cisgender patients for seeking the IUD. While TGD individuals on testosterone were more likely to have pain or an adverse procedural event, insertional success did not differ. One-year IUD continuation rates were similarly high in all groups.

研究目的：本研究比较了三种不同的青少年和年轻人（AYAs）在门诊寻求非镇静宫内节育器（IUD）插入的人口统计学特征和经历：(1)顺性别个体，(2)变性和性别多样化（TGD）个体接受性别肯定睾酮治疗，(3)TGD个体不接受性别肯定睾酮治疗。方法：本回顾性队列研究纳入13 ~ 21岁寻求宫内节育器植入的青少年。数据通过预先存在的多机构共享质量改进（QI）协作从电子健康记录中获得。患者群体特征采用描述性统计；推断统计学比较了手术并发症、结果和患者报告的副作用。未调整的Kaplan-Meier和Cox比例风险模型评估了延续率。结果：在683例尝试插入宫内节育器的参与者中，623例为顺性别个体，18例为使用性别确认睾酮的TGD个体，54例为未使用睾酮的TGD个体。插入指征无差异（p=0.25）。使用睾酮的TGD患者更有可能经历手术不良事件（17%,p=0.04），并报告超出预期的疼痛（p=0.003），尽管插入成功率在两组之间没有显著差异（p=0.22）。结论：TGD患者寻求宫内节育器的原因与顺性患者相似。虽然接受睾酮治疗的TGD患者更有可能出现疼痛或不良手术事件，但插入成功率并无差异。在所有组中，1年的宫内节育器延续率相似地高。

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引用次数: 0