Fertile Ground for Collaboration: A survey of pediatric surgeons on pediatric and adolescent gynecologic care

BACKGROUND: Pediatric and Adolescent Gynecology (PAG) emerged to bridge gaps between pediatrics and adult gynecology, while pediatric surgeons currently provide most operative gynecologic care for young patients. The goal of this survey was to understand pediatric surgical subspecialty perspectives on access to PAG services, perceived management patterns for common gynecologic conditions, and to assess opportunities for collaborative clinical and surgical care with PAG providers METHODS: A voluntary, anonymous, eight-question descriptive survey was distributed to members of the American Academy of Pediatrics Section on Surgery (SOSu) and Section on Urology (SOU). Survey questions assessed perceived PAG access, consultation patterns, coverage, and condition-specific management by subspecialty. Quantitative data were summarized descriptively, and qualitative free-text responses were analyzed thematically. RESULTS: Of 701 AAP SOSu and SOU members surveyed, 136 responded (19.4%). 63% reported access to PAG. PAG was perceived as primarily providing consultations (96%) and multidisciplinary support (58%). Pediatric surgeons self identified as the primary managers of most acute and congenital conditions. PAG was associated with endometriosis, ectopic pregnancy, and miscarriage management. Care for fertility preservation and Tuboovarian abscess/pelvic inflammatory disease(TOA/PID) were mixed. Free-text responses emphasized PAG's focused expertise and multidisciplinary value, with concerns regarding limited availability. CONCLUSIONS: This survey describes pediatric surgical subspecialty perspectives on pediatric and adult gynecologic care and access to PAG services. While pediatric surgeons manage many common gynecologic conditions, PAG providers serve as consultants, participate in multidisciplinary clinics, and offer specialized reproductive tract expertise. These findings highlight the importance of pediatric surgery while underscoring the value of expanding PAG within a collaborative model to meet evolving patient needs.