Gynecologic Assessment in CCPR

The gynecologic assessment with our Center for Colorectal and Pelvic Reconstruction (CCPR) team begins with a review of all medical records available to us at the time of intake. We ask families what their understanding is of the reproductive anatomy, and what questions or concerns they may have. This is where families play a huge role in helping to obtain medical records and assist us in putting together all the pieces of the puzzle.

When you meet with our team in clinic, we will sometimes try to do a gentle perineal examination during the office visit if you think your child will tolerate it. This exam helps us understand the anatomy on the outside of the body and whether there is a vaginal opening. Sometimes this exam is done in the operating room under anesthesia. We won’t do any examination that you and your child aren’t comfortable with us doing in clinic while the child is awake.

For certain cases, a vaginoscopy may be performed with other urologic or colorectal exams. This study is done under anesthesia where we use a small camera to look inside the vagina. The vaginoscopy helps us look at the lower gynecology system including the vaginal opening, entire vagina, and whether there is a cervix or two cervices at the top of the vagina.

If your child is going to undergo abdominal surgery with the colorectal or urology teams at any time throughout their care with CCPR, the gynecology team likes to be there to examine the uterine structures, fallopian tubes, and ovaries that are inside the body. This examination may be done at the time of any abdominal surgery whether laparoscopy with a camera, or during a laparotomy with an incision on the abdomen.

Putting all of these pieces of information about anatomy together gives the gynecology team a complete assessment to better prepare for puberty, the onset of menses, and even sexuality and family planning. Sometimes we can figure out all of the anatomy early in a child’s life, but other times it takes us longer to see how things develop as the patient grows and moves through puberty. We value educating patients and their families about their gynecologic anatomy to empower them as they move through life allowing them to grow comfortable in their bodies and understand what to expect moving forward into adulthood.