Česky
How does the approach to female patients in paediatric gynaecology differ compared to adult women?
During gynaecological examinations of children, it is necessary to create a friendly atmosphere, which removes shyness and fear of examination, fear of pain, especially in girls who visit a gynaecological office for the first time in their lives. Prior education by the mother who accompanies her daughter to the surgery plays an important role before the examination itself.
What examinations do you most often perform?
The most common examinations include vaginoscopy with the collection of material from the vagina for microbiological examination or for native evaluation of so-called functional hormonal cytology. Among the basic ones we also include transabdominal ultrasonographic examination of the pelvic organs, which requires a filled bladder of the child. In girls who have already had sexual intercourse, gynecological examination is performed as in adults.
Unfortunately, childhood activities often bring about injuries. Do you also encounter injuries to the genitals of young patients in your practice?
Of course, especially in the summer months, open - lacerations of the external genitalia prevail, which require treatment under general anaesthesia during hospitalisation.
What about the deployment of hormonal contraceptives in adolescent girls to treat severe forms of acne? There have been known cases of particularly religious mothers not taking it well with their daughters, fearing that it would lead the girls to start sexual activities prematurely. Have you encountered this problem?
Since girls with hyperandrogenic conditions are usually referred to the gynaecologist's office by paediatricians, dermatologists and especially paediatric endocrinologists, the mothers of these girls have no problem with the therapeutic use of combined hormonal contraceptives for this indication. The mothers' strict refusal is practically unheard of.
What are the benefits of hormonal contraception for adolescent girls, and what theoretical health risks might it bring them?
In addition to the contraceptive effect, we note a number of positive side effects such as regularization of the cycle, reduction of bleeding intensity, elimination of dysmenorrhea, premenstrual syndrome, prevention of ovarian cysts, influence on hyperandrogenic conditions, etc. To eliminate possible health risks, it is important to have an initial examination by a gynaecologist with collection of family and personal history data, especially with regard to thromboembolic diseases.
What are the problems of precocious puberty in girls?
The pediatric gynecologist in his office very often examines girls with various forms of precocious puberty, participating in their treatment in collaboration with a pediatric endocrinologist, because insufficient or inadequate treatment of precocious puberty can lead to serious damage to the child in the form of premature termination of his physical growth.
How important is collaboration with specialists from other disciplines in paediatric gynaecology?
Paediatric gynaecology is a predominantly outpatient specialty and interdisciplinary interaction with paediatric and adolescent general practitioners, hospital paediatricians, nephrologists, paediatric endocrinologists and surgeons is very important and valuable. It contributes to improving comprehensive care for children and adolescents.
