SERVICES
Paediatric Gynaecology

OVERVIEW

Paediatric gynaecology is a specialised branch of medicine that focuses on diagnosing, treating, and managing gynaecological ailments in children and teenagers from infancy to 18 years of age. Paediatric surgeons play a crucial role in providing gynaecological care to young girls. Many gynaecological issues in children are present from birth but may not become evident until later in life. It can cause significant distress for both parents and children. KZN Specialised Paediatric Surgical Service recognises the sensitivity required when approaching these cases to minimise emotional and physical trauma for young patients and their families. In some cases, a diagnosis may require anaesthesia and imaging studies. Treatment will depend on the diagnosis and be tailored to achieve the best possible outcome for each child.

Types of paediatric gynaecology conditions

Here are some common paediatric gynaecological conditions with a brief description of each:

Labial fusion: A condition in which the labia minora stick together, often as a result of irritation or infection, making it difficult for the child to urinate or causing discomfort.
Vaginal atresia: A congenital condition in which the vagina is either partially or completely absent, making it impossible for the child to menstruate or have sexual intercourse.
Imperforate hymen: This refers to a condition in which the hymen entirely covers the vaginal opening, leading to difficulty or impossibility of menstruation in children.
Ovarian cysts: Fluid-filled sacs that form on or within the ovaries, which can sometimes cause pain, bleeding, or other symptoms.
Breast abnormalities: Various conditions that affect the development of breast tissue in young girls, including breast lumps, masses, and asymmetry.
Genital trauma: Injury to the genitals, either accidental or intentional, which can cause pain, bleeding, or other symptoms.
Sexual abuse: Unwanted sexual contact, which can result in physical and emotional trauma for the child.

It's important to note that each case is unique and requires individualised care, and parents should consult with a Paediatric gynaecologist if they have any concerns about their child's reproductive health.

Symptoms of paediatric and gynaecological conditions

The symptoms of paediatric gynaecological conditions can vary depending on the specific condition. Nonetheless, the following are some of the most common symptoms that may necessitate paediatric gynaecological care:

Abnormal vaginal bleeding
Abnormal vaginal discharge
Breast lumps or masses
Difficulty urinating
Delayed onset of menstruation
Pain, swelling, or bleeding in the genital area due to an injury
Pain and discomfort in the pelvic area

Treatment

Surgery may be necessary for some paediatric gynaecological conditions, depending on the severity of the condition and the individual needs of the patient. Here are some common surgical procedures that may be performed:

Vaginal reconstruction: This surgery is performed for conditions such as vaginal atresia or vaginal agenesis, where the vagina is underdeveloped or absent. The surgery involves creating a vaginal opening and reconstructing the vaginal canal.
Hymenotomy: This is a minor surgical procedure that involves making a small incision in the hymen to create an opening. This is often done for girls with an imperforate hymen.
Ovarian cyst removal: When an ovarian cyst causes pain or other symptoms, surgery may be required to remove it. The procedure can be conducted laparoscopically, which entails making small incisions in the abdomen or through open surgery.
Labiaplasty: This surgery is performed for labial hypertrophy or other cosmetic concerns. The procedure involves removing the excess tissue from the labia minora to improve the appearance and function of the genital area.
Genital trauma repair: Surgery may be necessary to repair damage to the genital area caused by injury or trauma.
Breast surgery: Surgery may be necessary for breast abnormalities such as breast masses or asymmetry. The procedure may involve removing the mass or tissue or reconstructing the breast to improve symmetry.

REQUEST A CONSULTATION

Dr Mangray, the founder of KZN Specialised Paediatric Surgical Service, and his associates, Dr Ngobese, Dr Govender and Dr Dube-Zvirikuzhe, have a well-established reputation for caring for children right until late adolescence.

FREQUENTLY ASKED QUESTIONS

FAQ

1What should I expect during my child's first visit to a paediatric gynaecologist?

During the first visit, the paediatric gynaecologist will review your child's medical history and perform a physical examination. They may also ask questions about your child's menstrual history, sexual activity, and any symptoms they are experiencing.

2 Can girls get pregnant before they start menstruating?

Yes, it is possible for girls to get pregnant before they start menstruating. This can occur if ovulation occurs before the onset of menstruation. Initiating a conversation with your child about the significance of contraception and safe sex practices is crucial, and it should be done well before they experience their first menstrual cycle.

3Will my child need a pelvic exam?

Not all paediatric, gynaecological conditions require a pelvic exam. If your child is having symptoms like abdominal pain or abnormal vaginal bleeding, a pelvic exam may be required.

4Is it normal for young girls to experience vaginal discharge?

Yes, it is normal for girls to experience vaginal discharge as they approach puberty. If there is an accompanying itching, burning sensation, or an unpleasant odour, it may indicate an infection or another medical condition, and it's important to seek medical evaluation from a healthcare provider.