Clinical Characteristics of 600 Korean Pediatric and Adolescent Women Who Visited the Young Lady Clinic at Samsung Medical Center : 3 years Experience

Choi, D S; Ahn, K H; Yoon, B K; Lee, J H

Abstract

To analyze the clinical characteristics of six hundreds Korean pediatric and adolescent women visiting the Young Lady Clinic (adolescent gynecology clinic) at Samsung Medical Center, review of medical records was conducted from Feb. 1995 to Dec. 1997. The mean patient age was 17.0+/-5.9 years (mean+/-SD) with a range of 3 month to 25 years and the menarche being 12.8+/-1.4 years with a range of 10 to 18. The most common disease entity and disorder according to age groups were infectious disease and vaginitis in pediatric age group (group I), menstruation associated problems and dysfunctional uterine bleeding (DUB) in adole scent group (group II) and menstruation associated problems and amenorrhea in premarital age group (group III). Among gynecologic diseases, DUB was cited as the most common problem for visiting the Young Lady Clinic (146 cases, 23%). Ninety six patients (65.8%) with DUB were put on hormone therapy using progestin, estrogen, and monophasic oral pill etc. Of those with DUB, seven patients (4.8%) showed severe anemia with average hemoglobin level of 4.7 mg/dl, requiring admission and transfusion, and one patient had coagulopathy. Amenorrhea took second place, and twenty one patients (66%) with primary amenorrhea had a congenital defects such as structural anomaly like Mayer-Rokitansky-Kuster (M-R-K) syndrome or genetic defect like testicular feminization (TF) syndrome. Although secondary amenorrhea was usually considered as result of hypothalamic-pituitary (H-P) dysfunction, we found that 9 cases (10.8%) of premature ovarian failure and 9 cases (10.8%) of hyperprolactinemia. The most common infectious disease and the third common disorder was vaginitis. Using a catheter in catheter technique, predominantly isolated organisms varied according to age group (group I : Staphylococcus species, group II: E. Coli, group III: Candida albicans). Patients considered as having primary dysmenorrhea comprised 94% (78 cases) of total dysmenorrhea patients, and treated with mefenamic acid or aceclofenac resulted in symptomatic improvement in 96% of patients. Among the patients with pelvic tumor, 26 cases (54%) of the patients underwent operation, and 21 cases (81%) was due to ovarian tumor. The most common ovarian neoplasm was teratoma (10 cases, 48%). In conclusion, the most common gynecologic problem in Korean pediatric and adolescent women is disorders related to menstruation comprising 63.7% of patients visiting adolescent gynecology clinic. And vaginitis and pelvic tumors comprise more than 25% of the patients at our adolescent gynecology clinic.