Unité d'Endocrinologie et de Gynécologie Pédiatriques,
Hôpital Necker-Enfants Malades, Paris, France
Pediatric and adolescent gynecology is an emerging specialty, at the intersection of pediatrics, pediatric endocrinology, gynecology, pediatric surgery, dermatology, psychiatry, public health medicine and genetics. It thus addresses a wide spectrum of diseases from the newborn period to adolescence.
Progress in molecular biology and genetic research, as well as in imaging techniques, has greatly contributed to our understanding of the pathologies of gynecological development and, indeed, has helped to more clearly define the limits of physiological variation.
The gynecological problems encountered in children and adolescents are often both medically and psychologically complex and thus require a highly skilled and coherent approach. The adolescent, who is no longer a child but not quite an adult, poses a particular management problem to the traditional specialties.
In the field of adolescent gynecology more than anywhere else, the medical attitude is often striking by its extremes: from a seemingly indifferent 'wait-andsee' policy (true indifference or ignorance?) to an overzealous interventionism – and this at a developmental moment requiring great sensitivity and tact.
This volume does not exhaustively cover the entire field of pediatric and adolescent gynecology. Instead, its goal is to explore some of the most commonly encountered problems seen in clinical practice today. I am deeply grateful to the many experts who graciously agreed to contribute their insights and knowledge on different aspects of this broad field: together they represent a wealth of clinical experience firmly based on some of today's most exciting research. I have no doubt that their collective offering will enrich the work of practitioners the world over.
On a more personal note, let me conclude by expressing my great appreciation to Dr. Yvette Salomon-Bernard, one of the pioneers in Pediatric and Adolescent Gynecology; Prof. Raphael Rappaport, a longstanding leader in this field; Prof. Claude Migeon who first welcomed me to the Johns Hopkins University Hospital, and Prof. Roger Jean who was my mentor from the very beginning. All of them encouraged the young pediatric endocrinologist that I was (some years ago!) to broaden my clinical work to include pediatric and adolescent gynecology – and I thank them.