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Ovarian cyst and tumors
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Bryan J. Dicken, Deborah F. Billmire
Follicular cysts may be asymptomatic or present with pain due to large size, hemorrhage, or torsion. Most simple cysts will resolve spontaneously within three or four menstrual cycles. Indications for surgical intervention include persistent symptoms, pain, or evidence of torsion. As with neonatal non-neoplastic cysts, emphasis should be placed on ovarian parenchyma-preserving procedures.
Adnexal/Ovarian Torsion
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Hajra Takala, Mona Omar, Ayman Al-Hendy
Ovulation induction to treat infertility may cause multiple large ovarian follicular cysts, and large cysts carry an increased risk of torsion [47, 59]. In a study designed to determine the incidence of OT in patients after gonadotropins (ovulation induction treatment for either in vitro fertilization [IVF] or intracytoplasmic sperm injection [ICSI]). Operative laparoscopic conservative treatment (detorsion or unwinding the twisted adnexa) was performed in all of the patients. The study demonstrated that OT should be considered a major complications of assisted reproductive treatment, especially if patients are hyperstimulated (ovarian hyperstimulation syndrome [OHSS]), pregnant, or both [31].
A Functional Approach to Gynecologic Pain
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
When imaged, this “follicular cyst” may be described to the patient as though it is an abnormal growth on the ovary, rather than a normal, functional part of the menstrual cycle. Indeed, every woman who ovulates will have a “cyst” in the ovary every month. It is rare that a follicular cyst will cause pain, and its presence on imaging should not be construed as pathology. Other sources of pain should be investigated.
Paraovarian cystoadenofibroma: an unusual finding in two adolescent twin sisters
Published in Gynecological Endocrinology, 2022
Ilaria Acquaviva, Edoardo Bindi, Giovanni Torino, Giovanni Cobellis
Gynecologic neoplastic diseases are rare in pediatric population. Especially malignancies account for more or less 2% of all types of neoplastic conditions, with 60-70% arising from ovaries. The clinical entities most commonly encountered by the pediatric surgeon are benign ovarian lesions such as follicular, simple and luteal cysts [1]. On the other side, paraovarian masses are a relatively common finding, accounting for 5–20% of all adnexal lesions [2]. They can arise from the broad ligament between Fallopian tube and ovary, originating from mesothelial, mesonephric or paramesonephric tissue. They are usually of small dimension and rarely symptomatic [3]. Giant paraovarian masses are extremely uncommon during childhood and adolescence. They are usually detected in cases of abdominal pain with the suspicion of a torsion of ovaries due to ovarian cyst. Infact they cannot be distinguished from ovarian follicular cysts using any radiographic imaging technique [4]. In the Literature, there are only few reports about paraovarian lesions of relevant dimensions, in particular paraovarian cysts larger than 10 cm in diameter are extraordinarily unusual and anecdotal [5]. Currently the treatment of choice is complete excision of the cyst, preserving the fallopian tube and ovary. The most suitable approach is the minimally invasive one. In cases of large cysts, in which the laparoscopic technique is not feasible, an open technique with a small incision is still recommended. In this work we present two cases of giant paraovarian cysts in two 12 years-old twin sisters, treated with a mini-open approach.
Extended culture of cleavage-stage embryos in vitrified–thawed cycles may be an alternative to frozen and thawed blastocysts during in vitro fertilization
Published in Gynecological Endocrinology, 2022
Pinar C. Aytac, Esra B. Kilicdag
During the early phase of menstruation, transvaginal ultrasonography was done to analyze if there was any active follicular cyst. If there was no obstacle to starting IVF, all cycles were artificially prepared by 2 mg of oral estradiol, three times a day for 8 days. If endometrium thickness was greater than 7 mm, 90 mg progesterone vaginal gel was added two times a day for 4 or 5 days. In Group I, cleavage-stage embryos were thawed on the third day of progesterone treatment and monitored on the extended blastocyst culture medium every morning for 2 days to blastulation. Group II embryos were thawed and transferred after 2–3 h after expansion of blastocyst. In both groups, blastocyst embryos were transferred to the uterus on the fifth or sixth day of progesterone treatment. Hormonal treatment was recommended until 10 weeks of gestation.
Dydrogesterone primed luteal phase stimulation may be better than follicular phase stimulation in patients with diminished ovarian reserve
Published in Gynecological Endocrinology, 2021
Hulusi Bulent Zeyneloglu, Yusuf Aytac Tohma, Emre Gunakan, Gogsen Onalan, Tahir Eryılmaz
The use of LPS in fertility preservation strategies encouraged clinicians and leaded studies in groups of patients with poor ovarian response. Xu reported dual stimulation of a women with failed success in 2013 [3]. Then Kuang described Shangai protocol for poor responders, first to describe systematic subsequent ovarian stimulation in poor responders [4]. In addition, LPS may be administered in some norm-responder patients who frequently develop early follicular cyst and therefore yield low oocyte yield due to asynchronous follicular development. Luteal phase stimulation has been shown as effective as follicular phase in means of oocyte retrieval, embryo quality and euploidy [4–7]. However, all the treatments described until now, utilized complex stimulation protocols. In our clinic, we perform LPS (utilizing with dydrogesteron only instead of gonadotropin-releasing hormone antagonist) and FPS in two separate menstrual cycles (2–5 months intervals) instead of dual stimulation. In the literature, there were no studies comparing the efficacy of LPS and FPS in two separate menstrual cycles of the same patient. Therefore, in this study, we aimed to compare the efficacy of LPS and FPS in two separate menstrual cycles of the same patient, utilizing LPS with dydrogesteron only.