Gynecological Problems in Children: An Epidemiological Study at a Tertiary Level Hospital in Bangladesh

Abstract

Aims: Gynecological diseases in children are not similar to those that affect the adult. The aim of the study was to find out the pattern of gynecological problems in children presenting at a tertiary level hospital. Study Design:  Retrospective chart review. Place and Duration of Study: Department of Pediatric Surgery, Chittagong Medical College Hospital between January 2017 and June 2020. Methodology: This retrospective study was conducted on all admitted and outdoor patients with gynecological diagnoses. Demographic characteristics, type of problem, treatment and outcome were recorded among admitted patients. Patients with trauma to the external genitalia or perineum were analyzed for mechanism of injury, seasonal and age group variations, other associated injuries, and treatment. Results: There were 168 admitted and 300 outdoor patients. Age ranged from 3 days to 14 years among the admitted patients (mean 6.22 ± 3.41 years, median 7 years). Majority of the patients in OPD had labial adhesions (273, 91%) and majority of the admitted patients had trauma to the genitalia (86, 51%) followed by foreign body impaction (35, 21%) and birth defects (29, 17%). Ovarian dermoid (9, 5.36%), twisted ovarian cyst (9, 5.36%), disorders of sex development (DSD) (6,3.57%) were the commonest diseases. There were significant differences among age groups with regards to congenital and acquired conditions (P=0.00). Surgical procedures were performed in 92 (54.76%) patients and 76 (45.24%) patients had medical management. Conclusion: Gynecological problem may present in females at any age. Patterns vary between admitted and OPD patients. Labial adhesion, genital trauma and ovarian cysts are common among them. Sexual assaults on the young girls are areas of major concerns.