TY - CHAP M1 - Book, Section TI - Pediatric and Adolescent Gynecology A1 - Breech, Lesley A1 - Weber, Akilah A2 - Ziegler, Moritz M. A2 - Azizkhan, Richard G. A2 - Allmen, Daniel von A2 - Weber, Thomas R. PY - 2014 T2 - Operative Pediatric Surgery, 2e AB - It is important for pediatric surgeons to collaborate as a team with adolescent gynecologists, pediatric urologists, and endocrinologists for the diagnosis and management of complex gynecologic problems from infancy to late adolescence.Introital masses in infants with urinary symptoms are diagnosed by introital inspection done in either the frogleg or the knee/chest position, the differential diagnosis including aurethral prolapse or a prolapsed ureterocele.Hymenectomy is typically not necessary for mucocolpos in infancy because accumulated fluid will typically spontaneously resorb; however, in menarchal girls with breast development who present with pelvic and abdominal pain with failure to menstruate, hymenectomy is necessary to relieve the hematocolpos behind the obstructing hymen.Labial adhesions/agglutination that also obstruct the free flow of urine are best treated by topical estrogen or corticosteroids for a 4 to 6 week course to induce labial separation.Both simple and complex ovarian cysts diagnosed in utero or in the early neonatal period by ultrasound exam are best observed for 4 to 6 months if they are 5 cm or less in diameter and if they are asymptomatic, with the expected outcome being a complete spontaneous resolution.Ovarian preservation operative technique is the key directive when planning and carrying out excision of ovarian cysts or benign neoplasms, whether by open or laparoscopic technique. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/05 UR - accesssurgery.mhmedical.com/content.aspx?aid=1100436999 ER -