TY - CHAP M1 - Book, Section TI - Gynecologic Disorders of Infancy, Childhood, and Adolescence A1 - Moon, Lisa M. A1 - Perez-Milicua, Gisselle A1 - Dietrich, Jennifer E. A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. A2 - Schafermeyer, Robert Y1 - 2019 N1 - T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 5e AB - Congenital vaginal obstruction may present as an abdominal mass or bulge at the introitus.Treatment of asymptomatic labial adhesions is not indicated. For symptomatic relief, use estrogen cream as the first line of therapy.Urethral prolapse occurs most commonly in prepubertal African American females. Therapy with estrogen cream may reduce swelling of urethral tissue.Obtain a pregnancy test in all postmenarchal patients.Obtain a thorough sexual and menstrual history in all adolescent patients.Screen all sexually active patients for sexually transmitted infections (STIs).The diagnosis of ovarian torsion is clinical. Evidence of an abnormal or enlarged ovary on ultrasound, with or without Doppler flow studies, in addition to the physical exam can help with the diagnosis.In patients with complex ovarian cysts, tumor markers (e.g., AFP, serum HCG, LDH, and CA125) may be helpful to rule out malignancy.Treat most labial abscesses with incision and drainage; for Bartholin’s abscesses, insert a Word catheter.Pelvic pain can be caused by gynecologic and non-gynecologic sources, so it is important to evaluate all possible etiologiesConduct a gynecological examination (if amenable to it), wet prep collection, and investigation into STIs in patients with a complaint of vaginal discharge and/or pruritus.Most cases of genital trauma are accidental straddle injuries; however, consider the possibility of sexual abuse.If sexual abuse is suspected, contact child protective services (CPS). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/12 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1155429519 ER -