Transition from pediatric and adolescent gynecology to complex benign gynecology - who, what, and when?

Darington Richardson, Richardson D, Andrew Lupo, Lupo A, Marie Shockley, Shockley M
Current opinion in obstetrics & gynecology · 2026 · vol. 38(4) , pp. 291–298 · doi:10.1097/gco.0000000000001114 · PMID:42090296 · W7160436445
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-20 ⓘ

This review identifies a lack of formalized transition processes for pediatric gynecology patients with complex benign conditions and highlights the need for structured referrals to complex benign gynecology specialists for better outcomes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This article is a comprehensive review of recent literature on diagnoses that overlap pediatric and adolescent gynecology (PAG) and complex benign gynecology (CBG), aiming to clarify who should transition from PAG to CBG care and when and how that transition should occur. The review highlights that formalized transition processes are not well established for patients needing ongoing management of benign conditions, including endometriosis, abnormal uterine bleeding, chronic pelvic pain, and disorders of sexual development, and it notes that evidence links delays in diagnosing endometriosis and failure to refer to appropriate specialists with disease progression and worse long-term outcomes. A major limitation acknowledged is the lack of standardized, evidence-based transition frameworks and limited data on formal transition processes. Relevance to endometriosis: the paper specifically cites endometriosis among the chronic conditions lacking formal transition processes and discusses delayed diagnosis and referral as being linked to endometriosis progression and worse outcomes, though the paper is primarily a transition-of-care review across multiple gynecologic conditions.

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Abstract

PURPOSE OF REVIEW: The purpose of this article is to provide a comprehensive review of recent literature addressing diagnoses and conditions that intersect pediatric and adolescent gynecology (PAG) and complex benign gynecology (CBG) to inform which patients should make the transition from PAG to CBG care, as well as when and how that transition should occur. RECENT FINDINGS: Recent literature lacks data on formalized transition processes for pediatric gynecology patients who require ongoing management of benign conditions, including, but not limited to, disorders of sexual development, endometriosis, abnormal uterine bleeding, and chronic pelvic pain. CBG specialists are well positioned to assume care for many of these individuals. Evidence suggests that delays in diagnosing conditions like endometriosis and failure to refer to appropriate subspecialists are linked to disease progression and worse long-term outcomes, underscoring the need for timely referral. SUMMARY: Transition from PAG to CBG care is a critical juncture for patients with chronic and surgically complex conditions. Structured referrals, clear communication, and multidisciplinary collaboration are key to maintaining continuity of care, preserving fertility, and optimizing outcomes. Given the lack of standardized transition frameworks in gynecology, further research is needed to develop evidence-based protocols and reduce care fragmentation.
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aDepartment of Gynecology and Obstetrics, Emory University bDepartment of Gynecology and Obstetrics, Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA Correspondence to Darington Richardson, MD, Department of Gynecology and Obstetrics, Emory University, 5673 Peachtree Dunwoody Road, Suite 700, Atlanta, GA 30342, USA The purpose of this article is to provide a comprehensive review of recent literature addressing diagnoses and conditions that intersect pediatric and adolescent gynecology (PAG) and complex benign gynecology (CBG) to inform which patients should make the transition from PAG to CBG care, as well as when and how that transition should occur. Recent findings Recent literature lacks data on formalized transition processes for pediatric gynecology patients who require ongoing management of benign conditions, including, but not limited to, disorders of sexual development, endometriosis, abnormal uterine bleeding, and chronic pelvic pain. CBG specialists are well positioned to assume care for many of these individuals. Evidence suggests that delays in diagnosing conditions like endometriosis and failure to refer to appropriate subspecialists are linked to disease progression and worse long-term outcomes, underscoring the need for timely referral. Summary Transition from PAG to CBG care is a critical juncture for patients with chronic and surgically complex conditions. Structured referrals, clear communication, and multidisciplinary collaboration are key to maintaining continuity of care, preserving fertility, and optimizing outcomes. Given the lack of standardized transition frameworks in gynecology, further research is needed to develop evidence-based protocols and reduce care fragmentation. Plain Language SummaryThis review summarizes recent research on when and how patients should move from pediatric and adolescent gynecology (PAG) to complex benign gynecology (CBG) care for chronic and surgically complex conditions. The literature shows a lack of formal transition processes for patients with disorders of sexual development, endometriosis, abnormal uterine bleeding, and chronic pelvic pain who need ongoing management. CBG specialists are well suited to assume care, but delayed diagnosis and referral, especially for endometriosis, are linked to disease progression and worse outcomes. The authors highlight the need for structured referrals, clear communication, multidisciplinary care, and evidence-based transition protocols to preserve fertility and reduce care fragmentation. Text is machine generated and may contain inaccuracies. FAQ

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (28)

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