Gynecology is the smallest section in the surgery division at The Childrens Hospital. Over the past two years, the department has become a permanent part of the scene at The Childrens Hospital by virtue of regularly scheduled clinics, presence in the operating rooms, and regular interaction at an administrative/program planning level. Growth of the service has been modest, but steady. Increased demand for adolescent gynecological services is
anticipated over the next several years.
William Schlaff, MD
with thirteen-year-old Amanda
The department of Gynecology at The Childrens Hospital has continued to grow in areas of clinical care; educational support both within the hospital and to surrounding communities; and research activities. The department continues to provide a broad spectrum of gynecology services each week in the Adolescent Medicine Clinic at The Childrens Hospital. Issues involving pediatric vulva disorders, menstrual disorders, ovulation dysfunction, contraception, cervical dysplasia, pelvic pain and adnexal masses are addressed. Annual patient visits in 2001 and 2002 have increased by approximately 85% compared to visits in 2000. In 2001, a second clinic time was added to accommodate the increased volume. Intradepartmental referrals from Gastro-enterology, Hematology, Oncology and Endocrinology have steadily increased. An expanding referral base from the metro area, outlying regions and bordering states has been established in the last two years.
Twenty-four hour consultation service to the inpatient hospital and the Emergency Department at Childrens is provided. Consultation services have been extended to the Colorado Adolescent Maternity Program
(CAMP). CAMP is a multidisciplinary prenatal and postnatal program that addresses critical issues in adolescent maternal and child health. The department of Gynecology assists the child advocacy division in physical evaluation of suspected sexual trauma patients.
Surgical cases have seen an average increase of 60% in the two-year period compared to 2000. Increasing relationships with the departments of Pediatric Surgery and Urology have led to an increase in co-managed surgical procedures for patients requiring multidiscipline therapies. A total of nine procedures were performed in 2001 and 17 procedures in 2002. They included vaginoscopic evaluation of genital bleeding, laparoscopic evaluation of abdominal pain and treatment of endometriosis, congenital anomaly revision of the genital tract, repair of traumatic genital tract lacerations, removal of ovarian tumors with preservation of remaining ovarian function.
The department has increased its role in community support for activities in child advocacy through Stephen Scotts, MD, role as a member of the March of Dimes Political Action Committee.
Since January 1, 2001 the Department of Gynecology has provided numerous lectures related to pediatric and adolescent gynecology disorders at The Childrens Hospital and to pediatric and family practices and regional groups.
Clinical training includes instruction in adolescent gynecology for third-year residents of the University of Colorado Health Sciences Center Department of Gynecology. First-year adolescent medicine fellows from The Childrens Hospital receive clinical training during clinic and operating room time. The departments faculty provides Grand Rounds lectures to the pediatric departments of The Childrens Hospital and Denver Health Medical Center.
Research topics continue to develop in association with the department of Adolescent Medicine at The Childrens Hospital. Current areas of research include evaluating the effect of cervical dysplasia and its treatments on the cervical and vaginal environment, and how the timing of the administration of hormonal contraception affects bleeding patterns and long-term compliance.
Quality Performance Activities
Best practice consensus meetings are held monthly by the Gynecology and Adolescent Medicine departments. Quarterly, beginning in 2003, the University of Colorado department of Obstetrics and Gynecology will devote its gynecology morbidity and mortality conference to pediatric gynecology cases from The Childrens Hospital. Since 2000, Dr. Scott has been a member of the Clinical Outcomes Committee that monitors quality parameters within The Childrens Hospital.
Over the next several years, we hope to significantly expand our clinical activities and to develop collaborative programs with other groups at The Childrens Hospital. We anticipate involvement in the planning process and development of the new Childrens Hospital on the Fitzsimons campus.