title: A study of paediatric and adolescent gynaecology services in a British district general hospital.
abstract: OBJECTIVE
  The Paediatric and Adolescent Gynaecology service (PAG) at Kettering General Hospital is a designated service meeting the needs of children with gynaecological problems. National guidelines reinforce the fact that children should be seen within specific paediatric areas in hospital. We aim to review the role of such a service in the context of a British district general hospital.
  
  
  METHODS
  Retrospective review spanning 15 years.
  
  
  METHODS
  The outpatient/inpatient service of a UK district general hospital.
  
  
  METHODS
  A total of 800 patients were included in the study.
  
  
  METHODS
  We identified patients attending the PAG clinic between 1994 and 2009. Medical notes were reviewed individually.
  
  
  METHODS
  Demographics, referral source, presenting symptoms, examination findings, diagnosis, management, admissions and referrals to tertiary centres.
  
  
  RESULTS
  In total, 86% of patients were referred from primary care. The age distribution was bimodal at 4 and 15 years of age: the average age was 10 years. Sixty percent of patients were followed-up, giving a total of 2023 appointments. The commonest presentations were vulvovaginitis (18%), labial adhesions (14%), abdominal pain (7%) and precocious puberty (6%). A total of 15% of patients were admitted, largely for planned procedures, of which vaginoscopy was the most frequent.
  
  
  CONCLUSIONS
  The PAG service has enabled pathways for care that were previously non-existent, as well as the development of 'best practice'. The British Society for Paediatric and Adolescent Gynaecology has been seeking to develop a network of similar services at secondary and tertiary level throughout the UK. This approach should be encouraged and promoted by those in charge of healthcare policy and provider trusts in general.
authors.affiliation: Department of Obstetrics and Gynaecology, Kettering General Hospital, Kettering, NN16 8UZ, UK. smcgreal@doctors.org.uk
authors.forename: S
authors.initials: S
authors.lastname: McGreal
authors.forename: P L
authors.initials: PL
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004739:England; D005260:Female; D005831:Genital Diseases, Female / Q000628:therapy; D005836:Genitalia, Female / Q000002:abnormalities; D006767:Hospitals, District / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008599:Menstruation Disturbances / Q000628:therapy; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D011629:Puberty, Precocious / Q000628:therapy; D012189:Retrospective Studies; D012742:Sex Offenses; D014555:Urination Disorders / Q000628:therapy; D014848:Vulvovaginitis / Q000628:therapy; D014932:Women's Health Services / Q000706:statistics & numerical data*