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OBJECTIVE Delivery of reproductive services to adolescents varies by specialty and has been linked to differences in clinical training. Few studies have explored how different specialties’ graduate medical education (GME) programs prepare providers to deliver adolescent reproductive services. We explored the perceptions of resident physicians regarding their training in delivering adolescent reproductive health services. DESIGN Between November 2008 and February 2009, nine focus groups were conducted with graduate medical trainees in three specialties that routinely care for adolescents. The semi-structured discussions were audio-recorded, transcribed and analyzed using an inductive approach to content analysis. SETTING Large, urban academic medical center in Pittsburgh, Pennsylvania PARTICIPANTS 54 resident trainees in pediatrics, family medicine and obstetrics/gynecology INTERVENTIONS None MAIN OUTCOMES Trainees’ perspectives regarding the didactic teaching and clinical training in providing adolescent reproductive services RESULTS Five themes emerged reflecting trainees’ beliefs regarding the best practices GME programs can engage in to ensure that trainees graduate feeling competent and comfortable delivering adolescent reproductive services. Trainees believed programs need to: 1) Provide both didactic lectures as well as diverse inpatient and outpatient clinical experiences; 2) Have faculty preceptors skilled in providing and supervising adolescent reproductive services; 3) Teach skills for engaging adolescents in clinical assessments and decision-making; 4) Train providers to navigate confidentiality issues with adolescents and caregivers; and 5) Provide infrastructure and resources for delivering adolescent reproductive services. CONCLUSIONS The three specialties differed in how well each of the five best practices were reportedly addressed during GME training. Policy recommendations are provided.

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An estimated 500,000 cancer survivors of reproductive age in the United States will live to experience the long‐term consequences of cancer treatment. Therefore, a focused aspect of cancer care has appropriately shifted to include quality of life in survivorship. Infertility is a late effect of therapy that affects 12% of female survivors of childhood cancer receiving any cancer treatment in large cohort studies and results in a 40% decreased likelihood of pregnancy in young adults of ages 18–39 years. Nonfertility gynecologic late effects such as hypoestrogenism, radiation‐induced uterine and vaginal injury, genital graft‐versus‐host disease after hematopoietic stem cell transplant, and sexual dysfunction also significantly affect quality of life in survivorship but are underdiagnosed and require consideration. Several articles in the special edition “Reproductive Health in Adolescent and Young Adult Cancer Survivorship” address infertility, genital graft‐versus‐host disease, and psychosexual functioning in survivorship. This review article focuses on other adverse gynecologic outcomes of cancer therapies including hypogonadism and hormone replacement therapy, radiation‐induced uterovaginal injury, vaccination and contraception, breast and cervical cancer screening, and pregnancy considerations in survivorship.

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Background: Laparoscopic surgery has well-documented advantages, including better visualization, less postoperative pain, shorter hospital stays and recovery time, less adhesion formation and better cosmesis results. However, there only a few case series studying the efficacy and safety of laparoscopy for adnexal lesion in older children and adolescents. The aim of this study was to evaluate the outcomes of laparoscopic surgery for treatment of adnexal pathology in older children and adolescents. Methods: We retrospectively reviewed medical records of 69 pediatric and adolescent patients aged between 9 and 19 years who underwent laparoscopic surgery for adnexal pathology from January 2005 to September 2015. Patients who were pregnant or with non-gynecology pathology detected during operation were excluded from the study. Patients were divided into two groups according to their age: Group 1 consisted of 31 patients aged between 9 to 16 years and Group 2 included 38 patients aged between 17 and 19 years. Indication for surgery, procedures performed, anesthesia time, length of hospital stay, pathology findings and complication rate were evaluated. Results: The most common indication for laparoscopic surgery was detecting adnexal cystic mass determined incidentally or on the basis of symptoms such as abdominal pain. The second most common indication for surgery was acute abdominal pain with suspected adnexal torsion. The types of procedures performed for Group 1 and 2 are shown in Table