Laparoscopic Management of Ovarian Cysts

Ovarian cysts can be diagnosed in the fetal period, most of them in the third trimester of pregnancy. The incidence of presentation is of 1:2500 at referral centers. Three to five percent of children have small incidental ovarian cysts detected on ultrasound (US) [1]. It can be detected from the fetal period until adolescence. It is considered a pathological cyst when it has a diameter greater than 2 cm. However, it does not have the same meaning at one age or another. In neonates the pathological diagnoses usually are follicular cysts, intrauterine torsions, and, exceptionally, teratomas. In older girls, they are usually follicular cysts whose transcendence depends on the acquired size. When the cyst is accompanied by a solid component, we should suspect malignancy (teratomas or stromal tumors). In prepubertal girls with an ovarian mass or cyst, they should be operated if they are symptomatic or have poorly defined radiological signs. In adolescents, ovarian cysts must be related to the clinical history of menstruation and their sexual relations (Fig. 66.1).