RT Book, Section
A1 Breech, Lesley
A1 Weber, Akilah
A2 Ziegler, Moritz M.
A2 Azizkhan, Richard G.
A2 Allmen, Daniel von
A2 Weber, Thomas R.
SR Print(0)
ID 1100436999
T1 Pediatric and Adolescent Gynecology
T2 Operative Pediatric Surgery, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-162723-8
LK accesssurgery.mhmedical.com/content.aspx?aid=1100436999
RD 2024/04/16
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.