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The essential reasons in Pediatric Gynecology Practice Volume 21, issue 2, Avril-Mai-Juin 2018

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Authors
Hôpital des Enfants, Unité d’endocrinologie et de gynécologie médicale, Centre de référence de pathologies gynécologiques rares, 330 avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse Cedex 9, France
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Gynecological diseases of the child are a frequent pattern for consultation in liberal medicine. They are generally benign, their diagnosis requires a precise interrogation, a somatic and an external gynecological examination. Parents should be present in order to establish a climate of trust. The most suitable position is that of “the frog”. The use of MEOPA (nitrogen monoxide-oxygen mixture) and a nurse's aide are essential elements for a quality and conclusive gynecological examination. The main reasons for consultation are based on pain, leucorrhea or bleeding. Complementary examinations are rarely necessary except pelvic ultrasound. Local samples should not be systematic because they are painful and very often useless. In this chapter are discussed the essential points concerning the gynecological examination, the physiological variants of the hymen as well as the various vulvar affections. The different etiologies are largely dominated by vulvitis of the prepubertal girl for whom advice for urination is essential. Other specific childhood diseases are detailed such as those causing vulvar bleeding and suspicions of sexual abuse.

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