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 2024/10/05 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.