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

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.