Pediatric and Adolescent Gynecology in Europe: Clinical Services, Standards of Care, and Training

Abstract Study Objective To identify current clinical services and training available across Europe within pediatric and adolescent gynecology (PAG) and establish the extent to which PAG services meet current European Board and College of Obstetrics and Gynecology (EBCOG) standards. Design Quantitative and qualitative questionnaire. Setting European countries that are members of the EBCOG and the European Association of Pediatric and Adolescent Gynecology. Participants Thirty-six countries that were approached beginning in September 2013; data were obtained from 27 countries. Interventions Questionnaires with 28 stems were sent to clinical leaders in 36 European countries. Main Outcome Measures National society, national standards, legislation for female genital mutilation, protocols for transition to adult services, human papilloma virus vaccination programs, sex and contraception education, safeguarding, clinical leads for PAG, delivery of PAG services, and training available for PAG. Results Of 36 countries, 27 responded. Seventy-seven percent had a national PAG society but only 44% had national standards in PAG. There was agreement that PAG cases should be multidisciplinary but not all have clinical networks in place to facilitate this. Human papilloma virus programs are available in some European countries and not all have legislation against female genital mutilation. A significant proportion of cases continue to be seen in adult gynecology clinics as opposed to designated PAG clinics with only 41% with processes to transfer patients into adult care. Conclusion In this article we provide a framework to explore areas for improvement within PAG services and training across Europe. The EBCOG standards of care are not being adhered to in many countries because processes and clinical networks are not in place to facilitate them.