Journal of pediatric and adolescent gynecology最新文献

Study objective: The goal of this study was to describe the age ranges in which common genital, gonadal, and reproductive variations in sex characteristic (VSC)-related procedures are done and evaluate the variability in 30-day postoperative complications based on age range to address ongoing uncertainties about optimal surgery age for VSCs.

Methods: This was a retrospective cohort study utilizing data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database from 2012 to 2021. Included cases had a postoperative diagnosis associated with a VSC condition. Descriptive analyses were used. Fisher's exact test was used to test differences in complication risk.

Results: Our final analysis included 48,227 cases. Most cases were performed on individuals under the age of 3. When comparing the risk of any short-term, surgical complication by age category for each procedure, only three had significant age differences: ureter/bladder procedures had a higher risk of complications when performed in individuals under 11, and urethral/hypospadias surgeries and scrotoplasties had higher complication rates when performed in those 11 or older. In NSQIP-P, over 5 times as many vaginoplasties and clitoroplasties were performed under the age of 3 as over the age of 11. There were no differences across age groups for any assessed type of complication in either vaginoplasties or clitoroplasties.

Conclusion: There were few variations seen in NSQIP-P-assessed complications by age at the time of surgeries performed for VSCs, including in vaginoplasties and clitoroplasties. Many later surgeries do not appear to result in significantly worse intraoperative and 30-day postoperative outcomes.

Aim: The experience of dysmenorrhea can vary significantly between immigrant and non-immigrant adolescents. This study aims to compare the dysmenorrhea self-care practices among immigrant and non-immigrant adolescents.

Method: This study had a comparative cross-sectional design that was done in 2025. The population consisted of 209 immigrant and non-immigrant adolescent girls in 7th and 8th grade in Konya, Türkiye. Data were collected using the Adolescent Dysmenorrhea Self-Care Scale and a demographic form. Data was analyzed using independent samples t-tests, one-way ANOVA, and Pearson correlation coefficients. A p-value of less than 0.05 was considered as a statistically significant level.

Results: The mean age of participants was 13.71 years, and the average age at menarche was 11.84 years. Reported pain severity averaged 4.76 (maximum possible score: 10). The total dysmenorrhea self-care score averaged 87.85 (maximum possible score: 200), with significantly lower scores observed among immigrant adolescents (p < .001). Immigrants also reported a later age at menarche (p = .002) and lower scores in several dysmenorrhea self-care subdimensions. A moderate positive correlation was observed between pain severity and dysmenorrhea self-care (r = 0.394, p < .001), and a weak positive correlation was found between years lived in Türkiye and dysmenorrhea self-care (r= 0.181, p < .001).

Conclusion: Immigrant adolescents had lower dysmenorrhea self-care scores, later menarche, and relied more on traditional methods than Turkish peers, who practiced evidence-based care. Family and culture influenced self-care, while higher pain increased engagement. Culturally sensitive school and community education is vital to enhance menstrual health literacy and equitable self-care practices.

Background: Gastrointestinal adverse effects are common with selective serotonin reuptake inhibitors (SSRIs), yet menstruation‑specific cyclic gastrointestinal symptoms have not been described.

Objective: This report describes, to the best of our knowledge, the first documented case of menstruation-specific exacerbation of cyclic gastrointestinal symptoms associated with SSRI treatment and proposes a pragmatic management approach.

Case summary: A 20‑year‑old woman with generalized anxiety disorder developed nausea, vomiting, diarrhea, and dizziness limited to menstrual periods after initiating escitalopram 10 mg/d; gastrointestinal symptoms persisted following a switch to paroxetine 20 mg/d. A comprehensive gynecologic work‑up (pelvic examination, hormonal assessment, and ultrasonography) was unremarkable. The Naranjo Adverse Drug Reaction Probability Scale scored 7, indicating a "probable" menstruation-specific adverse reaction. Reducing paroxetine to 10 mg/d resolved gastrointestinal symptoms, but anxiety symptoms recurred; titration to 15 mg/d achieved psychiatric remission without gastrointestinal symptom recurrence. After 6 months of stability, paroxetine was tapered off without recurrence of either gastrointestinal or anxiety symptoms.

Key findings: This case demonstrates a menstruation‑modulated SSRI adverse effect mediated by a possible interaction between serotonergic signaling and cyclical sex steroid fluctuations.

Implications: An interdisciplinary, stepwise strategy (ruling out gynecologic disease, considering dose optimization, and monitoring menstruation‑linked symptoms) may help balance efficacy with tolerability in reproductive‑age patients. Prospective studies should evaluate SSRI-hormone interactions and menstrual-aware adverse effect monitoring.

Study objective: This review aims to systematically examine the global distribution, health consequences, and sociocultural drivers of female genital mutilation/cutting (FGM/C), with the aim of informing targeted elimination strategies.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Web of Science, and Elsevier Science Direct from inception to July 2025 for studies examining FGM/C prevalence patterns, determinants, and health effects. Eligible studies were in English, addressed at least one of the review's thematic domains, and had ethics approval. Data from 329 articles were extracted and synthesized within the Socio-Ecological Model framework.

Results: FGM/C is mainly practiced in Africa (with national prevalence exceeding 80% in some countries) and persists within immigrant diaspora communities in Europe, North America, and Australia. While prevalence has declined in regions such as East Africa, progress has stalled in parts of West Africa and Sudan. Key drivers include limited education, deep-rooted social and religious norms, marital and economic incentives, and poverty. Legal bans exist in over 80 countries, yet enforcement gaps, cultural resistance, and medicalization hinder elimination. Across all 4 WHO-defined types, FGM/C is linked to acute and chronic physical complications (eg, hemorrhage, urogenital injury, obstetric morbidity), profound psychological sequelae (eg, PTSD, depression, sexual dysfunction), and substantial economic burden on healthcare systems.

Conclusions: Eliminating FGM/C requires integrated, context-specific strategies that combine strong legislation, community engagement, educational initiatives, and expansion of survivor-centered medical and psychosocial care. Linking these actions to broader Sustainable Development Goals could accelerate progress toward ending FGM/C by 2030.