The importance of vaginoscopy in premenarchal girls with vaginal bleeding- call for more PAG practioners

IntroductionPrepubertal vaginal bleeding outside the neonatal period is always abnormal and very alarming to both parents physicians. The variable etiologies of vulvovaginitis are most common causes during prepubertal period.We report a series three cases observed „covid“ 2020-2022.Case reporttwo patients 8 9 year -old girls, were refered pediatric secondary center due external bleeding. Hormonal levels pre-pubertal bone age was not advanced. Both girls hospitalized sellar X-ray pelvic MRI done further course, revealing etiology bleeding.Six months after first bleeding, they reffered gynecologist where foreign bodies (grass seed) found vaginoscopy.Third patient, 3-year- old girl, examined by her pediatrician because heavy analysis suggestive precocious puberty. Additional analyses revealed elevated alpha fetoprotein level (>5000 IJ,), which led diagnosis yolk sac tumor in vagina wall, then confirmed vagionoscopy biopsy.SummaryIt important perform vaginoscopy premenarchal with repeated older than five years, reason for body but younger patients, primary goal exclude malignant tumor. Prepubertal period. We 2020-2022. two Six vaginoscopy. Third biopsy. It 1. Ng SM, Apperley LJ, Upradrasta S, et al: Vaginal Bleeding Pre-pubertal Females, Journal Pediatric Adolescent Gynecology 2020; 33:339