Unilateral tubo-ovarian agenesis with contralateral adnexal torsion in a premenarchal girl.

Unilateral adnexal agenesis is a rare entity. Most of these cases are reported in reproductive age group. A case of a 10-year-old premenarchal girl is reported who presented with acute abdominal pain and vomiting. BothUltrasonography (USG) and MRI suggested right ovarian mass with torsion. Laparoscopic evaluation revealed an enlarged right ovary with torsion and contralateral agenesis of uterine tube and left ovary. Detortion of the ovary and an ovarian fixation to the ovarian pedicle was done. This is the first reported case of a premenarchal girl presenting with an acute abdomen due to adnexal torsion along with contralateral tubo-ovarian agenesis.

Comparison of Two Techniques of Laparoscopy-Assisted Peritoneal Vaginoplasty.

Neovagina creation is essential for patients with the Mayer-Rokitansky-Kuster-Hauser syndrome. We compared a technique involved the pushing down of the peritoneum with the technique of separating the peritoneum for laparoscopy-assisted peritoneal vaginoplasty. We collected patients with congenital absence of vagina who underwent laparoscopy-assisted peritoneal vaginoplasty of the First Affiliated Hospital of Zhengzhou University between January 2011 and May 2013. The 2 surgical groups (pushing group and separating group) were compared for various parameters. The values of the following parameters were significantly lower for the pushing group compared with the separating group: mean operating time (78 ± 13 minutes vs 135 ± 28 minutes), mean duration of hospitalization (12.9 ± 2.7 days vs 18.0 ± 3.8 days), mean cost of hospitalization (14 016 ± 1640 RMB vs 18 783 ± 2143 RMB), requirement for a drainage tube (4% vs 27%; χ(2) = 8.864), requirement for analgesic drugs (20% vs 40%; χ(2) = 3.977), and postoperative rehospitalization (3.3% vs 10.0% at 2 months and 6.7% vs 26.7% at 6 months; χ(2) = 4.268 and 5.196). Mean values for blood loss (57 ± 19 mL vs 66 ± 20 mL), time to pass gas (21 ± 4 hours vs 23 ± 7 hours), and length of the reconstructed vagina (9.0 ± 0.4 cm vs 8.9 ± 0.5 cm) were not significantly different between the 2 groups. In addition, mean postoperative Female Sexual Function Index score did not differ significantly between the 2 groups or among the 2 groups and a control group (27.0 ± 4.8 vs 26.7 ± 5.2 vs 27.9 ± 4.5; p > .05). The technique involving pushing down of the peritoneum offers advantages of reduced cost, complications, hospitalization, operative time, and pain over the traditional technique. Sexuality approaches so-called "normal" sexuality.

Congenital and acquired pathology of ovary and tubular genital organs in ewes: a review.

Advances in our understanding of ovarian cyclicity, pathogenesis of subfertility and/or infertility and reproductive pathology in food animals have frequently entailed examination of abattoir material. Despite the fact that most lesions in ewes are likely to be of relatively minor significance to fertility, results of previous studies suggest that lesions of the female reproductive system may represent a significant source of loss to sheep husbandry. The objective of this paper is to review the pathophysiology, the effects on reproductive efficiency and the key gross and histological diagnostic features of congenital and acquired pathology of ovary and tubular genital organs in ewes.

A study of ovarian lesions in pre-menarche girls.

OBJECTIVE: To analyze various clinical presentations and the surgical management of ovarian pathologies in pre-menarche girls. DESIGN: Case series. PLACE AND DURATION OF STUDY: Surgical Unit B, National Institute of Child Health, Karachi, from September 2002 to August 2004. PATIENTS AND METHODS: Case records of all the pre-menarche girls child having an ovarian pathology and managed during the study period were reviewed. Age of the patients, presenting symptoms, investigations performed, surgical approaches, operative findings and final histological diagnosis were noted. Ovarian lesions were classified according to WHO criteria.System proposed by the Children's Cancer Group and the Paediatric Oncology Group was used for staging of tumors. Following resection, patients with malignant tumors were followed-up by oncologist. RESULTS: There were 18 patients with ovarian lesions. Age range of patients was from day 1 to 13 years. Mass in abdomen was the most common presenting symptom (60% patients ) followed by pain (50%). Right ovary was involved in 12 (55%) cases and left in 6 (45%). Six patients had non-tumorous cysts, 3 had benign tumors and 9 were with malignant lesions. Of the non-tumorous cysts, 3 patients had simple follicular cysts and 2 were hemorrhagic cysts. There were 2 patients with benign teratoma and one with dermoid cyst. Four patients had malignant teratoma, 4 dysgerminoma and one yolk sac tumor. Malignant tumors were all of stage IA according to Paediatric Oncology Group staging. CONCLUSION: Ovarian tumors are rare in paediatric age group especially in pre-menarche girls. Except one, all malignant tumors were found in patients above 7 years of age. Benign (tumorous and non-tumorous) and malignant lesions occurred with equal frequency in pre-menarche girls in this study.

[Chance finding of foetal and neonatal ovarian cysts on echography]. / Foetale en neonatale ovariumcysten als toevalsbevinding bij echografie.

Cystic abnormalities of the adnex were found by chance in 2 baby girls, one aged 2.5 months and the other aged 2 months. Both had been born dysmaturely and the abnormalities were found on echographic investigation carried out for suspected urinary-tract infection. On monitoring investigation one month later, the abnormalities had become smaller and some time later had disappeared altogether. With the increasing use of ultrasound, ovarian cysts are being detected more often in the foetus and neonate. The majority of these cysts are benign functional follicular cysts and resolve spontaneously. The decision to perform surgery depends on the clinical symptoms and appearance on ultrasound. Large uncomplicated cysts can be managed by antenatal or postnatal aspiration in order to prevent torsion and the subsequent loss of the adnex.

Pediatric gynecologic ultrasound.

This article reviews salient features of pediatric gynecologic ultrasound. It reviews technologic factors, technique, and normal anatomy used to evaluate the pediatric gynecologic tract for abnormality. It reviews and illustrates clinical imaging information necessary to know in the ultrasonic analysis of several clinical problems in the pediatric gynecologic tract. This includes ovarian torsion, ambiguous genitalia, pelvic mass, and precocious puberty, as well as acute pelvic pain occurring from newborn life through puberty.

Two dermoid cysts developing in an accessory ovary and an eutopic ovary.

Accessory ovary is a rare gynecologic condition, and tumors arising in accessory ovaries are extremely rare. Accessory ovary may result from separation of migrating ovaries during embryogenesis and injuries such as inflammation and operation on normal ovary. Congenital malformations, most frequently malformations of the genitourinary organ, are seen in connection with the accessory ovary. We experienced the first case of two dermoid cysts developing in an accessory ovary located in the left infundibulopelvic ligament and another in the eutopic ovary at the same side concurrently. Here, we present this extremely rare case with a review of the literature.

[Congenital abnormalities of the peritoneo-vaginal process]. / Les anomalies congénitales du canal péritonéo-vaginal.

The different clinical manifestations resulting from abnormalities of the development of the peritoneovaginal process are reviewed: inguinal hernias, abnormal testicular descent, herniated ovary, hydrocele of the tunica vaginalis, hydrocele of the spermatic cord. The pathogenesis is studied on the basis of the embryology of the vaginal processus. The surgical aspects are discussed.

[The syndrome of ovarian hypoplasia]. / Uber das Syndrom der Ovarialhypoplasie

The authors, on the basis of broad and endocrinological studies and of histological investigation of the ovaries, performed in 21 women, described an uniform disease picture which allowes to delimit ovarian hypoplastic syndrome out of a group of patients with ovarial insufficiency. This syndrome is characterized by primary or secondary amenorrhoea, normal height, weak development of secondary sexfeatures, and by small ovaries which have the oval or roller, more seldom ball-like or streaking form. The histological picture of the ovaries consist of fibrous stroma without generative elements or with a small number of primary follicles, but sometimes also with single growing Graaf's follicle. The excretion of estrogens is very low and in the case of gonadotrophins it increases.