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Pediatric/Adolescent Gynecology Specialists Address Unique Needs

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Two years ago, Brittany, then 15, had excruciating, intense pain in her lower right side; she was diagnosed with a large ovarian cyst. Her parents were extremely concerned. Doris, Brittany’s mother, contacted Jonathan Trager, MD, an adolescent medicine specialist in Williston Park, who immediately sent her to Heather Appelbaum, MD, director of Long Island Jewish (LIJ) Medical Center’s new Division of Pediatric and Adolescent Gynecology.

“Brittany was definitely nervous. We all were,” explained Doris. “When Brittany was 5, her doctor told us that she only had one ovary. Now, here I was meeting Dr. Appelbaum for the first time, and the next thing I knew, my daughter was being rushed to the hospital for surgery. But as nervous as I was, I knew Brittany was in good hands because Dr. Appelbaum put us at ease. She was professional and nurturing at the same time. And most importantly, she made Brittany feel safe in a very frightening situation.”

After her examination, Brittany was rushed into surgery to remove a large hemorrhagic cyst that was bleeding into her right ovary. Dr. Appelbaum was concerned that the cyst might be twisting, which could cut off the blood supply to Brittany’s ovary, essentially killing it. Losing her only ovary would result in permanent infertility and premature menopause at age 15.

Sensitivity and Skill

“We have a very special approach for the children and families who seek help from us,” said Dr. Appelbaum. “Young girls are usually very anxious about seeing a gynecologist. They worry about the exam and fear potential complications with their reproductive organs. Often the girls do not fully understand their symptoms or the implication of their diagnoses. And, of course, parents may also be concerned about how their daughters will tolerate the evaluation and how their diagnoses will affect future fertility and childbearing.”

Dr. Appelbaum leads a multidisciplinary team devoted to providing the highest quality care for conditions affecting the pediatric and adolescent female reproductive system. Conditions they address include vaginal infections, menstrual irregularities, abnormal bleeding, endometriosis, polycystic ovary syndrome, genital trauma, birth defects and disorders of sexual development.

For Brittany, Dr. Appelbaum performed minimally invasive laparoscopic surgery to remove the cyst. While doing so, she located Brittany’s second ovary. Not only was Brittany relieved of her pain, but she was also relieved of worry about potential compromise to her future fertility.

“The anatomy, physiology and pathology of a developing girl are dramatically different from those of an adult woman,” said Dr. Appelbaum. “We evaluate each child to determine how it will affect her future.”

Disorders of Sexual Development

Specialists in LIJ’s Division of Pediatric and Adolescent Gynecology are skilled in pelvic reconstructive surgery for congenital anomalies of the reproductive system. Working collaboratively with colleagues at the Steven and Alexandra Cohen Children’s Medical Center of New York, the division is the New York area’s only place that specializes in treatment of sexual development disorders. A team of physicians, which includes pediatric gynecologists, pediatric urologists, pediatric endocrinologists, pediatric psychiatrists and medical geneticists, works together to provide a continuum of care for girls born with incomplete or malformed reproductive organs. Dr. Appelbaum is one of the few doctors in this country who specializes in current techniques for vaginal agenesis, a congenital disorder that occurs when the vagina stops developing. “What used to take up to six months can now be accomplished in 10 days,” said Dr. Appelbaum. The minimally invasive procedure is commonly performed in late adolescence.

“LIJ established the Division of Pediatric and Adolescent Gynecology to address the complex medical needs of these patients,” said Ron Sliwinski, senior administrative director of the Department of Obstetrics and Gynecology at LIJ and North Shore University Hospital. “We assembled a superior group of specialists so patients can get the best, most comprehensive care.”

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For more information on pediatric and adolescent gynecology, call (866) 690-2008.

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