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Ovarian cysts in neonates, children and adolescents
1Department of Obstetrics and Gynecology, University of Missouri, Kansas City, Missouri 64108, USA. stricklandjl@umkc.edu
Insights
Understanding normal ovarian physiology in young females reveals that ovarian cysts are common and often resolve naturally. New guidelines emphasize conservative management and less invasive surgical techniques when intervention is needed.
Area of Science:
- Reproductive Endocrinology
- Pediatric Gynecology
- Medical Imaging
Background:
- Ovarian physiology in neonates, prepubescent girls, and adolescents is complex and varies with age.
- Ovarian cysts are frequently observed in pediatric and adolescent populations.
- Distinguishing normal physiological cysts from pathological ones is crucial for appropriate management.
Purpose of the Study:
- To enhance understanding of normal ovarian physiology across different pediatric age groups.
- To establish evidence-based management guidelines for ovarian cysts in neonates, prepubescent girls, and adolescents.
- To review current diagnostic and therapeutic approaches for pediatric ovarian cysts.
Main Methods:
- Comprehensive literature review of studies on pediatric ovarian physiology and cyst management.
- Analysis of ultrasound findings in the context of ovarian follicular development and atresia.
- Evaluation of clinical outcomes associated with conservative and surgical interventions.
Main Results:
- Ultrasound imaging has significantly improved the understanding of ovarian cyst development as a normal consequence of follicular dynamics.
- Ovarian cysts are common in all age groups, frequently regress spontaneously, and rarely indicate malignancy.
- Emerging management strategies focus on recognizing ovarian torsion for prompt intervention and employing minimally invasive, tissue-sparing surgical techniques.
Conclusions:
- Appreciation of normal ovarian follicular growth in immature females facilitates the understanding of physiological cyst development.
- Conservative management, including observation, is often effective and can replace surgical intervention for many ovarian cysts.
- Knowledge of advanced, less invasive surgical techniques improves ovarian tissue preservation rates when treatment is necessary.
Purpose Of Review:
This review is intended to increase the understanding of normal ovarian physiology in neonates, prepubescent girls and adolescents and to outline management guidelines for ovarian cysts at each age.
Recent Findings:
Ultrasound has increased the level of understanding regarding the development of ovarian cysts. With ultrasound, ovarian cysts are recognized as a consequence of follicular growth and atresia that can be a normal developmental occurrence at all ages. Clinical experience has taught us that ovarian cysts are common, frequently regress without treatment and are seldom associated with malignancy. New management schemes are developing which rely on increased recognition of torsion and prompt intervention to untwist the adnexa and leave it in situ. In addition, new operative techniques are being developed that are less invasive and morbid, as well as being more conservative of ovarian tissue.
Summary:
With the understanding of normal ovarian follicular growth in girls prior to full maturity, the normal development of ovarian cysts can be appreciated. Conservative therapies with observation can often replace surgical management. When treatment is necessary, knowledge of less invasive and morbid techniques can improve ovarian preservation rates.