Paediatric and Adolescent Gynaecology

Paediatric and Adolescent Gynaecology

Paediatric and Adolescent Gynaecology is a sub-specialty of Gynaecology, which deals with the problems of the female organs in girls from age 0 to 18 years of age.

Important Point to Understand:

The age of infancy, childhood and teenage years is a very vulnerable age. When girls in these ages have any health problems related to female organs, it has been well recognised that 95% of parents instinctively take their daughters to see the pediatricians or general physicians. This is because they have the misconception that a female only needs to see a Gynaecologist once she is older.

It has now been internationally recognised and well documented with strong evidence that pediatricians or general physicians do not know how to treat female problems in young girls. This results in misdiagnosis and mistreatment of the girl-child.

Incorrect treatment will lead to worsening of the problem in the short term, and harmful long-term effects on the girl-child’s future Gynaecological health.

If the parents of these young girls take their daughters to a well trained and experienced Paediatric and Adolescent Gynaecologist, their daughters will benefit with:

  • Correct diagnosis of her current problem
  • Early detection of any future problems and
  • Institution of appropriate treatment

This will ensure the best possible outcomes in terms of future sexual function, urinary function and potential fertility of their daughters.

Common Problems seen in Paediatric and Adolescent Gynaecology Patients:

These can be as follows:

  • Normal physiological discharges:
    • In babies
    • In little girls
    • In teenage girls
  • Skin problems of genitalia:

    Disorders of the skin in this area can present at any age. Incorrect treatments will subject these young girls to unnecessary, incorrect and harsh treatments, which have a negative effect on their current and future health.

  • Variations in physical changes at puberty
  • Ovarian cysts
    • These can occur in any age

      Example: Once parents are told that their 5-year-old daughter or 13 year old daughter has a cyst in one or both her ovaries, their natural tendency is to take their daughter to a general surgeon or a pediatrician.

      It has now been proven with research that these are completely the wrong specialties to deal with problems of ovarian cysts in females from age 0-18. Research shows that because paediatric surgeons and general surgeons are not familiar with the normal changes in the ovaries in young female patients, shockingly, they tend to remove the ovarian cysts together with the normal ovaries in these little girls. This results in serious affect on the future fertility of these girls.

  • Period problems
    • Early periods
    • Late periods
    • No periods
    • Irregular periods
  • Pelvic Pain
    • Simple pain occurring with periods
    • Complex acute or chronic pelvic pain

      There are many causes of Acute and Chronic Pelvic Pain in paediatric and adolescent girls and the management of each is different.

  • Problems of urinary bladder control
    • Problems of bed wetting
    • Urinary urgency
    • Urge incontinence
    • Frequency of passing urine in day and night
    • Urinary tract infections

    Delay in treatment or incorrect treatment can result in severe long-term debilitating and embarrassing bladder problems.

  • Hormonal Problems
    • Estrogens/Testosterones/Progestogens
  • Polycystic Ovarian Syndrome
  • Body image issues
  • Management of gynaecological aspects of adolescent girls with medical conditions such as diabetes, renal problems, childhood cancers etc.
Uncommon Problems in Adolescents:
  • Genetic Problems:
    • Turner Syndrome
    • Down Syndrome
    • Androgen Insensitivity Syndrome
    • Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome
    • Mullerian abnormalities: A few are given below
      • Imperforate hymen
      • Transverse vaginal septae
      • Longitudinal vaginal septae
      • Rudimentary uterine horns
    • The XY Female Intersex
    • Congenital Adrenal Hyperplasia
  • Premature Ovarian Insufficiency
  • Congenital Disorders: Some congenital disorders present for the first time in adolescence

In addition, to the above issues, young girls may have complex and rare medical conditions which need specialized care and treatment.

Period Problems in Girls with Physical and Learning Difficulties:

This is an extremely important and sensitive issue. The period problems faced by teenage girls who suffer with physical and learning disabilities are not only distressing for them but also their loved ones and carers. Dr (Mrs) Salma Kayani has been specifically trained by the Royal College of Obstetricians and Gynaecologists (UK) to especially manage and treat period problems in this special group of adolescent girls. Dr (Mrs) Salma Kayani is considered an international expert in this area and has written papers as an expert for the Royal College of Obstetricians and Gynaecologists (UK) to teach and train other Gynaecologists on how to manage these problems in this very vulnerable and neglected group of young girls.

International Publication-Adolescent Gynaecology

Review Article:
Jeffery E, Salma I Kayani, Garden A. Management of menstrual problems in adolescents with learning and physical disabilities. The Obstetrician & Gynaecologist 2013; 15:106-12 DOI: 10.111/tog.12008

Member of International Organistions

Dr (Mrs)Salma Kayani is member of the following prestigious international organizations relating to Paediatric and Adolescent Gynaecology

  • British Society for Paediatric and Adolescent Gynaecology (BritSPAG)
  • North American Association for Paediatric and Adolescent Gynaecology (NASPAG)
Training, Skill and Experience of Dr (Mrs) Salma Kayani

The field of Paediatric and Adolescent Gynaecology is a rare, highly specialized and increasingly recognised as an area in which specific knowledge and expertise is required to ensure that these young girls achieve the best outcome.

Dr (Mrs) Salma Kayani has been specially trained by the Royal College of Obstetricians and Gynaecologists (UK) appointed leading authorities in Paediatric and Adolescent Gynaecology in the medical and surgical management of problems in this age group of girls.

She is an extremely skilled expert and has 14 years of experience in this highly specific sub specialty of Gynaecology.

Paediatric and Adolescent Gynaecology :

  • Laparoscopic Gonadectomy for Disorder of Sex Development
  • Laparoscopic Correction of Mullerian Structural Disorders
  • Vaginoscopies

In addition to the above keyhole operations, Dr (Mrs) Salma Kayani has been trained to perform the following highly specialised advance minimal access procedures in this group of young girls.

Highly specialised advanced minimal access procedures in Paediatric and Adolescent Gynaecology:

  • Laparoscopic Gonadectomy for Disorder of Sex Development
  • Laparoscopic Correction of Mullerian Structural Disorders
  • Vaginoscopies