Gynecology is a department that most people think is only for adult women, especially married women, how can a little girl have gynecological problems? Pediatric and adolescent females from birth to maturity is the stage of growth and development of the female organism, especially the development of female reproductive organs and secondary sexual characteristics, the process of psychosexual development, which may be affected by genetics, environment, nutrition and drugs, the occurrence of diseases such as: congenital malformations, inflammation, tumors, precocious puberty, menstrual disorders and trauma.
Pediatric gynecology has the following common conditions.
Vulvovaginitis is the most common pediatric gynecological disorder. It manifests as itchy vulva, painful urination, frequent urination, yellowish staining of underwear, and vaginal bleeding in severe cases. When infants cannot express it, they show it by scratching their vulva or pants, crying when urinating, or being reluctant to urinate.
Causes of vulvovaginitis.
Anatomic features.
The vaginal opening is adjacent to the urethral opening and anal opening, and urine and fecal juice can contaminate the vaginal opening. The vulva is underdeveloped, the labia minora cannot cover the vaginal opening, and the vulva is not protected by pubic hair, all of which can make the child susceptible to germs.
Physiological characteristics.
Due to low estrogen levels and low lactobacilli in the vulva of pediatric patients, the vulvar skin is alkaline, which can also cause invasion of germs.
Poor lifestyle habits, such as prolonged use of diapers or wipes, not washing the vulva or improper washing methods, using tub baths, wearing tight nylon pants, and not wiping the vulva after urinating.
In the case of dysplasia, such as urinary fistula and anal fistula, long-term urine and fecal contamination can cause vulvovaginal infections.
Obesity, diabetes mellitus, and low immunity can also cause vulvovaginitis.
Treatment of vulvovaginitis.
1. Wash the vulva, making sure to push open the labia majora and labia minora to wash the dirt away.
2. Put eye drops through the vaginal opening for anti-inflammatory treatment, or apply eye ointment to the vestibular area.
3.Teach the affected children some common sense of hygiene to prevent recurrent attacks. For example, when urinating, spread your legs apart and wipe from the front to the back before standing up. Obese children can face the back seat, that is, face the toilet to urinate, to prevent urine from flowing into the vagina.
Labia minora adhesions are caused by long-term inflammatory stimulation and improper care, making both labia minora closed and the vaginal opening and urethral opening invisible, which some parents think is a congenital deformity and are very frightened. Labia minora adhesions usually occur in children from 3 months to 8 years old. Some children have no discomfort and are only detected during physical examinations or abnormal urinary lines. Take your child to a pediatric gynecologist when he or she struggles or cries when urinating, when the urine stream deviates, when the urine line becomes thin, and when the urine line is bifurcated.
Etiology of vaginal foreign body.
1. Foreign body enters the vagina when the child is playing in the grain pile, mud or pond with open pants or without pants.
2. The child is curious or stuffs it into the vagina to relieve itching, or is stuffed into the vagina by a playmate.
3. A foreign body is inserted into the vagina of the child by a sexual abuser.
The foreign body may show increased vaginal discharge, vaginal bleeding, and in long term, infection with foul-smelling purulent discharge or blood-purulent discharge. If the foreign body is not removed, it can cause recurrent vaginitis and in severe cases, vaginal atresia, which can affect future fertility.
Hymenal atresia is a common congenital abnormality of the genital tract. It may not manifest itself in infancy. It is only discovered when menstruation occurs during puberty, when menstrual blood cannot flow out of the vaginal opening because of atresia, causing painful clothing. Hymenal atresia should be considered if an adolescent girl has periodic abdominal pain or progressive increase in abdominal pain that interferes with urination and defecation.
Common causes of vaginal bleeding.
1. Vulvovaginitis. Inflammatory exudate bloody discharge, eczema chafing or scratching of the affected child.
2, trauma. Such as straddling injury or man-made injury.
3.Foreign body. Vaginal foreign body not removed for a long time can cause pus and blood discharge.
4.Tumor. Urethral mucosal prolapse of vulva, endodermal sinus tumor and grape sarcoma of vagina, granulosa cell tumor of ovary, etc. can cause vaginal bleeding.
5.Premature sexual maturity. Misuse of birth control pills, lesions in the hypothalamus, ovaries and adrenal cortex can cause precocious puberty, which can lead to vaginal bleeding.
Precocious puberty is diagnosed when breasts develop before the age of 8 weeks and menstruation starts before the age of 10. Recent survey data shows that most of the precocious puberty in children is caused by excessive intake of estrogen-containing food, high protein diet, taking too many tonic products too early, too little sleep, uncontrolled use of computer, cell phone, iPad, and even overnight light on. However, a very small number of young children with precocious puberty are caused by lesions in the hypothalamus, ovaries, adrenal cortex and other parts of the body, to be vigilant, it is best to go to the hospital for diagnosis.
Menstrual disorders The imperfect development of the hypothalamic-pituitary-ovarian axis during puberty and the influence of multiple factors such as strenuous activities, mental tension, emotional changes or diseases in the internal and external environment can lead to dysfunctional uterine bleeding, polycystic ovary syndrome, amenorrhea and dysmenorrhea during puberty. If you have heavy menstruation, long duration, dysmenorrhea that affects your study life, or if you still have scanty menstruation or amenorrhea two years after your first menstruation, please visit a hospital.