• Nian N. Ameen Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. & Pediatric Surgery Unit, Shar Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.
  • Mahdi A. Marif Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Wirya N. Saber Pediatric Surgery Unit, Shar Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.
  • Tharwat M. Muhssen Pediatric Surgery Unit, Shar Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.



Pediatric gynecology, Ovarian cyst, Imperforate hymen, Sulaimani



Neonatal and pediatric gynaecological problems are those gynecologic disorders among younger females. Although they are common problems in Sulaimani province, but pediatric surgical unit receive most of the congenital disorders, while the acquired one usually referred to other department, with lack of a guideline for management. 



To ascertain the magnitude of neonatal and pediatric gynaecological disorders encountered in pediatric surgery unit in Sulaimani and to discover the pattern of presentation and principles of management with clarifying some of the anatomical variation in the rare anomalies with measuring its prevalent rate.

Patients and Methods

A prospective hospital based study carried out on 173 patients, all were females with gynecologic problems and have been managed at Pediatric Surgical Unit at the Sulaimani Pediatric Teaching Hospital and Shar Hospital, between Dec 2006 and Dec 2016. Excluding cases of trauma either sexual or accidental, cases of persistent cloaca, and vestibular anus. The data collected, including age, presenting complaints, type of the abnormality. The findings on physical examinations, investigations and operative procedures were collected and discussed, statistical analysis done by SPSS-21 , p value<0.05 regarded significant .


During the study period, 173 patients had been managed from a gynecological pathology. Their ages ranged from few hours to 12 years, preschool age group was the most frequent (32.6%) and (30.64%) of them had acquired anomalies. Labial adhesion and ovarian cysts were the most frequently encountered neonatal/ pediatric gynecological disorders. The main presenting complains was abnormal looking genitalia.


Gynecological problem not restricted to adolescent or women, it may present in females at any age. Neonates may complain from acquired anomalies, although it is more common in preschool group. Pediatric atmosphere can calm fears about what can be a traumatic experience. Pediatric surgeon manage the congenital anomalies in majority, while acquired cases mostly managed by gynecologists, pediatricians, urologists, and family medicine doctors’ without same guide line for management.


Hasan L, Diejomaoh MF, Al-Harmi J, Mohd AT. The scope of pediatric and adolescent gynecological problems in Kuwait. Medical principles and practice: international journal of the Kuwait University, Health Science Centre. 2010; 19(5):384-9. DOI:

Cheikhelard A, Chaktoura A, Thiband E .Gynecologic Clinical Examination of the Child and Adolescent. In: Saltan C. Pediatric and Adolescent Gynecology Evidence-Based Clinical Practice. 2nd ed. Switzerland: Karger; 2012.P. 2-10. DOI:

Davis A. Adolescent Gynecology. In: Gibbs RS, Karlan BY, Haney AF, Nygaard I, Danforth Obstetrics and Gynecology. 10th ed. Philadelphia: Lippincott-Willianms and Willeins; 2008.P.555-566.

Laufer MR. Abnormalities of the female Genital Tract. In: Coran AG, Adzick NS, Krummel TM, Laberge JM, Caldamore A, Shamberger R. Pediatric Surgery. 7th ed. Philadelphia: Elsever/Saunders; 2012. P.1591-1609. DOI:

Presannakumari B. Embryology of the Female Genital Tract and its Congenital Anomalies. 1st ed. New Delhi: Jaypee; 2011.P.26-30. DOI:

Hertweck P, Yoost J. Common Problem in Pediatric and Adolescent Gynecology. Expert Reviews of Obstetrics and Gynecology .2010; 5(3). DOI:

Hurwitz RS. Disorder of the female external genitalia. In: Godbole PP, Koyle M A, Wilcox DT. Guide to pediatric urology and surgery in clinical practice.1st edition.London: Springer; 2011.P. 95-106 DOI:

Yordan EE, Yordan RA .The early historical root of pediatric and adolescent gynecology. Journal of Pediatric & Gynecology. 1997; 10(4):183-91. DOI:

Silva D, Jayalath GK, Ranaweera AK, Jayawardane M, Sudeshika MD. A new method of surgical treatment for recurrent labial adhesions in a pre-pubertal girl. The Ceylon medical journal. 2012; 57(4):168-9. DOI:

Muram D, Ransom S B, McNeeley S B. Pediatric and Adolescent gynecology. In: Ransom S B, Mitchell P, Dombrowski W B .Practical Strategies in Obstetrics and Gynecology.1st ed. Philadelphia: Saunders; 2000.P.82-89.

Mayoglou L, Dulabon L, Martin-Alguacil N, Pfaff D, Schober J. Success of treatment modalities for labial fusion: a retrospective evaluation of topical and surgical treatments. Journal of pediatric and adolescent gynecology. 2009; 22(4):247-50. DOI:

Akin MA, Akin L, Ozbek S, Tireli G, Kavuncuoglu S, Sander S, et al. Fetal-neonatal ovarian cysts--their monitoring and management: retrospective evaluation of 20 cases and review of the literature. Journal of clinical research in pediatric endocrinology. 2010; 2(1):28-33. DOI:

Mor N, Merlob P, Reisner SH. Tags and bands of the female external genitalia in the newborn infant. Clinical pediatrics (Phila). 1983; 22(2):122-4. DOI:

Koumantakis EE, Hassan EA, Deligeoroglou EK, Creatsas GK. Vulvovaginitis during childhood and adolescence. Journal of pediatric and adolescent gynecology. 1997; 10(1):39-43. DOI:

Mukhopadhyay M, Shukla RM, Mukhopadhyay B, Mandal KC, Ray A, Sisodiya N, et al. Ovarian cysts and tumors in infancy and childhood. Journal of Indian Association of Pediatric Surgeons. 2013; 18(1):16-9. DOI:

Reichardts KW. Ovarian Tumors, In: Mattei P. fundamentals of pediatric surgery. New York: Springer; 2011. P. 441-749.

Fallat ME, Lagnacio RC. Ovarian tumors. In; Puri P, Hollwarth ME. Pediatric surgery: Diagnosis and Management. London: Springer; 2009.P. 745. DOI:

Liu H, Wang X, Lu D, Liu Z, Shi G. Ovarian masses in children and adolescents in China: analysis of 203 cases. Journal of ovarian research. 2013; 6:47. DOI:

Choudry A, Bangash N, Malik A, Choudry H. Adolescent ovarian tumors: a clinicopathlogical review of 15 cases. Journal of Ayub Medical College, Abbottabad : JAMC. 2008; 20(4):18-21.

Merriman TE, Auldist AW. Ovarian torsion in inguinal hernias. Pediatric surgery international. 2000; 16(5-6):383-5. DOI:

Runck LA, Method A, Bischoff A, Levitt M, Pena A, Collins MH, et al. Defining the molecular pathologies in cloaca malformation: similarities between mouse and human. Disease models & mechanisms. 2014; 7(4):483-93. DOI:

Feldkamp ML, Botto LD, Amar E, Bakker MK, Bermejo-Sanchez E, Bianca S, et al. Cloacal exstrophy: an epidemiologic study from the International Clearinghouse for Birth Defects Surveillance and Research. American journal of medical genetics Part C, Seminars in medical genetics. 2011; 157C (4):333-43. DOI:

Singh S, Singh P, Singh RJ. Persistent Urogenital Sinus. Journal of Anatomical Society of India. 2010; 59(2):242-244. DOI:

Saleem M, Iqbal MZ, Jam MR, Ahmad M, Mirza B. Colovaginoplasty in a case of mayer-rokitansky-kuster-hauser syndrome. APSP journal of case reports. 2014; 5(1):7.

Tanos V. Vaginal Septae and imperforate hymen .In: Grimbizis GF, Campo R, Tarlatzis BC, Gordts S. Female Genital Tract Congenital Malformation Classification, Diagnosis and Management. Springer: London. 2015. P. 231-241. DOI:

Pevendra K, Sharma G, Sharm Sh. Hydrometrocolpos. In: Puri P, Höllwart M. Pediatric Surgery Diagnosis and Management. Springer: London. 2009 .P. 959-968.

Parente Hernandez A, Angulo Madero JM, del Canizo Lopez A, Sanchez Paris O, Romero Ruiz RM, Vazquez Estevez J. [The paraurethral cyst or Skene’s duct cyst in the female newborn]. Actas urologicas espanolas. 2006; 30(1):93-4. DOI:

Jayasinghe Y, Garland SM. Genital warts in children: what do they mean? Archives of disease in childhood. 2006; 91(8):696-700. DOI:

Lacey C J N, Woodhall S C, Wikstrom A , Ross J.2012 European Guideline for the Management of Anogenital Warts. J Eur Acad Dermatol Venereol. 2013 Mar; 27(3):e263-70. doi: 10.1111/j.1468-3083.2012.04493.x. Epub 2012 Mar 12. DOI:

Sinclair KA, Woods CR, Kirse DJ, Sinal SH. Anogenital and respiratory tract human papillomavirus infections among children: age, gender, and potential transmission through sexual abuse. Pediatrics. 2005; 116(4):815-25. DOI:



How to Cite

Ameen N, Marif M, Saber W, Muhssen T. NEONATAL AND PEDIATRIC GYNECOLOGICAL PROBLEMS; PATTERNS AND PRESENTATION. JSMC [Internet]. 2017 Dec. 21 [cited 2024 Jul. 22];7(4):361-9. Available from:

Similar Articles

1-10 of 421

You may also start an advanced similarity search for this article.