Percutaneous drainage as the treatment of choice for neonatal ovarian cysts.
BACKGROUND
Involution of neonatal ovarian cysts occurs usually by 12 months. Persisting cysts larger than 4 cm are prone to torsion. Two modes of therapy are advocated: surgery and percutaneous US-guided cyst aspiration.


OBJECTIVE
To compare ovarian preservation following the use of US-guided aspiration or conventional surgery for the treatment of large asymptomatic neonatal ovarian cysts, and to suggest alternative treatment when intrauterine ovarian torsion occurs.


METHODS
The study population comprised 25 baby girls with an ovarian cyst, 5 with a simple cyst and 20 with a complex cyst. Of these 25 infants, 8 had surgery and 17 had US-guided cyst aspiration.


RESULTS
In the surgical group of 8, 6 underwent oophorectomy, and in 2 the ovary was saved. In the aspirated group of 17, the ovary was saved in 10, and was lost in 5. At the time of this report one patient was still in the follow-up period, and one was lost to follow-up.


CONCLUSIONS
US-guided aspiration of large neonatal cysts preserves ovarian tissue in a higher percentage of patients than surgery. It is safe, effective, and repeatable. We recommend US-guided aspiration of asymptomatic large ovarian cysts for salvage or for decompression if intrauterine ovarian torsion occurs. Surgery should be reserved for patients with acute torsion, intestinal obstruction and intestinal volvulus.
Kessler
Ada
A
Department of Radiology, Tel Aviv Souraski Medical Center, 6 Weizman, Tel Aviv, 64239, Israel. kesslera@tasmc.health.gov.il
Nagar
Hagith
H
Graif
Moshe
M
Ben-Sira
Liat
L
Miller
Elka
E
Fisher
Drora
D
Hadas-Halperin
Irith
I
D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional