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Ota K, Takahashi T, Ajiro Y, Nohara S, Shuno Y, Kamiyama H, Kobayashi T. Unilateral Ovarian Hypoplasia with Ipsilateral Fallopian Tube Hypoplasia. J Minim Invasive Gynecol 2023; 30:685-686. [PMID: 37209946 DOI: 10.1016/j.jmig.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/11/2023] [Indexed: 05/22/2023]
Affiliation(s)
- Kuniaki Ota
- Department of Obstetrics and Gynecology (Dr. Ota), Tokyo Rosai Hospital, Tokyo, Japan; Fukushima Medical Center for Children and Women (Drs. Ota and Takahashi), Fukushima Medical University, Fukushima, Japan
| | - Toshifumi Takahashi
- Fukushima Medical Center for Children and Women (Drs. Ota and Takahashi), Fukushima Medical University, Fukushima, Japan.
| | - Yoshiki Ajiro
- Department of Surgery (Drs. Ajiro, Nohara, Shuno, Kamiyama, and Kobayashi), Tokyo Rosai Hospital, Tokyo, Japan
| | - Shigeo Nohara
- Department of Surgery (Drs. Ajiro, Nohara, Shuno, Kamiyama, and Kobayashi), Tokyo Rosai Hospital, Tokyo, Japan
| | - Yasutaka Shuno
- Department of Surgery (Drs. Ajiro, Nohara, Shuno, Kamiyama, and Kobayashi), Tokyo Rosai Hospital, Tokyo, Japan
| | - Hirohiko Kamiyama
- Department of Surgery (Drs. Ajiro, Nohara, Shuno, Kamiyama, and Kobayashi), Tokyo Rosai Hospital, Tokyo, Japan
| | - Takashi Kobayashi
- Department of Surgery (Drs. Ajiro, Nohara, Shuno, Kamiyama, and Kobayashi), Tokyo Rosai Hospital, Tokyo, Japan
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Chen HA, Grimshaw AA, Taylor-Giorlando M, Vijayakumar P, Li D, Margetts M, Pelosi E, Vash-Margita A. Ovarian absence: a systematic literature review and case series report. J Ovarian Res 2023; 16:13. [PMID: 36642704 PMCID: PMC9841619 DOI: 10.1186/s13048-022-01090-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/24/2022] [Indexed: 01/17/2023] Open
Abstract
Ovarian absence is an uncommon condition that most frequently presents unilaterally. Several etiologies for the condition have been proposed, including torsion, vascular accident, and embryological defect. A systematic review was conducted to describe the clinical presentation of ovarian absence, as well as its associations with other congenital anomalies, through a systematic search of Cochrane Library, ClinicalTrials.gov, Google Scholar, Ovid Embase, Ovid Medline, PubMed, Scopus, and Web of Science. Exclusion criteria included cases with suspicion for Differences of Sex Development, lack of surgically-confirmed ovarian absence, and karyotypes other than 46XX. Our search yielded 12,120 citations, of which 79 studies were included. 10 additional studies were found by citation chasing resulting in a total 113 cases including two unpublished cases presented in this review. Abdominal/pelvic pain (30%) and infertility/subfertility (19%) were the most frequent presentations. Ovarian abnormalities were not noted in 28% of cases with pre-operative ovarian imaging results. Approximately 17% of cases had concomitant uterine abnormalities, while 22% had renal abnormalities. Renal abnormalities were more likely in patients with uterine abnormalities (p < 0.005). Torsion or vascular etiology was the most frequently suspected etiology of ovarian absence (52%), followed by indeterminate (27%) and embryologic etiology (21%). Most cases of ovarian absence are likely attributable to torsion or vascular accidents, despite many references to the condition as "agenesis" in the literature. Imaging may fail to correctly diagnose ovarian absence, and diagnostic laparoscopy may be preferable in many cases as genitourinary anatomy and fertility considerations can be assessed during the procedure. Fertility is likely minimally or not affected in women with unilateral ovarian absence.
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Affiliation(s)
| | - Alyssa A Grimshaw
- Yale University, Harvey Cushing/John Hay Whitney Medical Library, New Haven, CT, USA
| | | | - Pavithra Vijayakumar
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Dan Li
- Yale University School of Medicine, New Haven, CT, USA
| | - Miranda Margetts
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA
| | - Emanuele Pelosi
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Alla Vash-Margita
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale New Haven Hospital, New Haven, CT, USA.
- Yale Department of Obstetrics, Gynecology & Reproductive Medicine, Farnam Memorial Building, 310 Cedar Street, Fl 3, Rm 329, New Haven, CT, 06510, USA.
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Choi MG, Kim JW, Kim YH, Kim AM, Kim TY, Ryu HK. Congenital ovarian anomaly manifesting as extra tissue connection between the two ovaries: A case report. World J Clin Cases 2022; 10:9318-9322. [PMID: 36159438 PMCID: PMC9477659 DOI: 10.12998/wjcc.v10.i26.9318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/16/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ovarian anomalies except for uni- or bilateral streak gonads are rare. We present a rare case of an ovarian anomaly in which both ovaries were connected by extra tissue.
CASE SUMMARY A 32-year-old, primipara with a twin pregnancy at 36 weeks of gestation was admitted to the hospital with severe preeclampsia. She underwent emergency cesarean section owing to persistent headache, blurred vision, and general edema. Following a peritoneal incision, a thin rectangular-shaped tissue was seen in front of the uterus. After delivery, the extra tissue was removed; no other anomalies were reported in either the ovaries or uterus. Pathology results of the removed tissue disclosed a well-vascularized loose stromal tissue with few follicles and scattered luteinized cells. In this case, to prevent pelvic adhesion or intestinal obstruction resulting from volvulus, strangulation, and torsion, the extra tissue was removed.
CONCLUSION We report a case of a rare ovarian anomaly where both ovaries were connected by extra tissue. If the extra tissue extends to the abdominal cavity, it should be removed to prevent pelvic adhesion or abdominal complications including intestinal volvulus, strangulation, and torsion.
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Affiliation(s)
- Myeong Gyun Choi
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - Jong Woon Kim
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - Yoon Ha Kim
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - A Mi Kim
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - Tae Young Kim
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - Hyun Kyung Ryu
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
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Gupta N, Nigam A, Tripathi R, De A. Unilateral tubo-ovarian agenesis with contralateral adnexal torsion in a premenarchal girl. BMJ Case Rep 2018; 2018:bcr-2017-224157. [PMID: 29735499 DOI: 10.1136/bcr-2017-224157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Nidhi Gupta
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, Delhi, India
| | - Aruna Nigam
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, Delhi, India
| | - Reva Tripathi
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, Delhi, India
| | - Arpita De
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, Delhi, India
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Abstract
A 32-year-old woman, who presented for laparoscopic sterilization after two full-term normal deliveries, was incidentally diagnosed to have a left-sided complex cyst in the pouch of Douglas (POD). She had no history of previous surgeries or any symptoms of lower abdominal pain, nausea, or vomiting in the past. She underwent laparoscopy, and the left ovary and distal portion of the fallopian tube were absent in their normal position. An ectopic left ovary with dermoid cyst was noted in the POD. The right ovary and tube were in their normal position. I attribute this to be a very rare case of asymptomatic torsion and autoamputation of the ovary resulting in an ectopic ovary.
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Affiliation(s)
- Bimal Mathew John
- Department of Minimally Invasive Surgery, Credence Hospital, Trivandrum, Kerala, India
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Manjiri S, Padmalatha SK, Shetty J. Management of Complex Ovarian Cysts in Newborns - Our Experience. J Neonatal Surg 2017; 6:3. [PMID: 28083489 PMCID: PMC5224760 DOI: 10.21699/jns.v6i1.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/19/2016] [Indexed: 11/11/2022] Open
Abstract
Aims: To analyse the clinical presentation, clinicopathological correlation and management of complex ovarian cysts in newborn and infants.
Materials and Methods: Over a period of 6 years (2009-2015), 25 newborns who were diagnosed to have ovarian cyst on antenatal ultrasound, were followed up. We collected data in the form of clinical features, radiological findings, pathology and mode of treatment.
Results: Of the 25 fetuses who were diagnosed to have ovarian cysts, fourteen (56%) underwent spontaneous regression by 6-8 months. Eight were operated in newborn period while 3 were operated in early infancy. Seven had ovarian cyst on right side, 4 had on left side. Eight babies underwent laparoscopy while 3 underwent laparotomy. Histopathology showed varied features of hemorrhagic cyst with necrosis and calcification, serous cystadenoma with hemorrhage, benign serous cyst with hemorrhage and simple serous cyst. Post-operative recovery was uneventful in all.
Conclusion: All the ovarian cysts detected antenatally in female fetuses need close follow-up after birth. Since spontaneous regression is known, only complex or larger cysts need surgical intervention, preferably by laparoscopy. Majority of the complex cysts show atrophic ovarian tissue hence end up in oophorectomy but simple cysts can be removed preserving normal ovarian tissue whenever possible.
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Affiliation(s)
- S Manjiri
- Department of Pediatric Surgery, M.S. Ramaiah Medical College, Bangaluru-560054, India
| | - S K Padmalatha
- Department of Pediatric Surgery, M.S. Ramaiah Medical College, Bangaluru-560054, India
| | - J Shetty
- Department of Pediatric Surgery, M.S. Ramaiah Medical College, Bangaluru-560054, India
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Agenesia ovárica unilateral y malformaciones fetales en una mujer embarazada con síndrome de hiperinmunoglobulinemia E. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2016. [DOI: 10.1016/j.gine.2015.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Aamir M, Punia H, Dalal P, Sharma D. Conservative management of a large neonatal ovarian cyst: a case report. J Clin Diagn Res 2015; 9:SD04-5. [PMID: 26023615 DOI: 10.7860/jcdr/2015/12717.5805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 02/20/2015] [Indexed: 11/24/2022]
Abstract
We describe a case of a large simple neonatal ovarian cyst, which was managed successfully using "wait and watch" approach and serial ultrasound monitoring. A cystic lesion arising from right ovary was noted in antenatal ultrasound (USG) which was followed up with postnatal USG which revealed a large simple ovarian cyst without any complications. Patient was kept on expectant management with close clinical and USG monitoring. Cyst resolved spontaneously at 10 wk of age. A brief review of literature for likely aetio-pathogenesis and management is also presented.
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Affiliation(s)
- Mohd Aamir
- Fellow (Neonatology) Department of Pediatrics, Division of Neonatal Services, PGIMS , Rohtak, Haryana, India
| | - Harish Punia
- Junior Resident, Department of Pediatrics, PGIMS , Rohtak Haryana, India
| | - Poonam Dalal
- Associate Professor, Department of Pediatrics, PGIMS , Rohtak, Haryana, India
| | - Deepak Sharma
- DNB (Neonatology), Fernandez Hospital , Hyderabad, Telangana, India
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Grigoras D, Pirtea L, Sas I, Matusz P. Unilateral ovarian agenesis with partial ipsilateral tubal agenesis. J OBSTET GYNAECOL 2014; 35:428-9. [PMID: 25243719 DOI: 10.3109/01443615.2014.958444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- D Grigoras
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy 'Victor Babes' Timisoara , Romania
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The auto-amputated adnexa: a review of findings in a pediatric population. J Pediatr Adolesc Gynecol 2013; 26:305-13. [PMID: 23287601 DOI: 10.1016/j.jpag.2012.08.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 08/01/2012] [Accepted: 08/21/2012] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE To quantify our experience and that of the literature with diagnosis and management of the auto-amputated adnexa in a pediatric population. DESIGN Case series and literature review. SETTING Tertiary care medical center. PARTICIPANTS Case series of pediatric patients (<18 years of age) with surgically documented adnexal auto-amputation collected from our medical center and the literature. INTERVENTIONS None. MAIN OUTCOME MEASURE Auto-amputated adnexa. RESULTS In addition to the 3 cases discussed from our institution, 91 cases of auto-amputated adnexa were identified in the literature dating back to 1943, for a total of 94 cases. Forty-nine percent (46/94) of the cases involved girls in a pediatric population (<18 years of age). Of these, the majority (n = 26) were identified in a subgroup of girls who were diagnosed with an adnexal cyst by antenatal ultrasound. Most of these neonates were asymptomatic at birth or had a palpable abdominal mass (n = 6) and at the time of surgical exploration were found to have an auto-amputated adnexa. 34 out of 46 cases were analyzed in detail. The right adnexa were involved in 56% of the cases. The most common presenting complaint verbalized by the older girls was pain; however, 8 cases were identified in asymptomatic girls undergoing unrelated diagnostic testing. CONCLUSION The auto-amputated adnexa is a rare finding in the pediatric population, but it must be considered as a possible explanation for the incidental finding of absence of the fallopian tube or ovary in the subgroup of patients who undergo surgery for any reason. Patients with an antecedent history of pelvic pain either chronic or intermittent in nature may be diagnosed with torsion or less frequently auto-amputation of the adnexa. A fetal "pelvic mass" or "ovarian cyst" may predispose the adnexa to torsion and subsequent auto-amputation either in-utero or post-delivery. Many of these antenatally diagnosed cysts and even subsequent auto-amputations are completely asymptomatic, however, and do not compromise fertility assuming the contralateral adnexa are normal. Thus expectant management is appropriate for small (less than 4 cm), asymptomatic simple cysts and even suspected auto-amputated adnexa in an asymptomatic patient.
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Castellani C, Petnehazy T, Gürtl-Lackner B, Saxena AK. A rare cause for a neonatal cystic abdominal mass. J Minim Invasive Gynecol 2013; 20:714-6. [PMID: 23680516 DOI: 10.1016/j.jmig.2013.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 03/28/2013] [Accepted: 03/31/2013] [Indexed: 10/26/2022]
Abstract
Intrauterine ovarian torsion is a rare event, but it is a possible cause for unilateral ovarian aplasia. Most commonly the ovary undergoes autolysis after torsion so that no tissue or remnants can be discovered on the involved side. We report a rare case of unilateral intrauterine torsion followed by autoamputation and abdominal reimplantation resulting in an intra-abdominal complex cystic mass with a review of the literature.
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Affiliation(s)
- Christoph Castellani
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.
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12
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Taşkın EA, Cırık DA, Çalışkan AC, Ortaç A, Tuğlu A. Unilateral Absence of the Fallopian Tube and the Ovary: Report of Two Cases and Brief Review of the Literature. J Gynecol Surg 2013. [DOI: 10.1089/gyn.2012.0076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Elif Aylin Taşkın
- Department of Obstetrics and Gynecology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Derya Akdağ Cırık
- Department of Obstetrics and Gynecology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Ahmet Cantuğ Çalışkan
- Department of Obstetrics and Gynecology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Arzu Ortaç
- Department of Obstetrics and Gynecology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Alper Tuğlu
- Department of Obstetrics and Gynecology, Samsun Education and Research Hospital, Samsun, Turkey
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13
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Tanaka Y, Koyama S, Kobayashi M, Kubota S, Nakamura R, Isobe M, Shiki Y. Complex Müllerian malformation without any present classification: unilateral ovarian and tubal absence with an arcuate uterus. Asian J Endosc Surg 2013; 6:55-7. [PMID: 23347709 DOI: 10.1111/j.1758-5910.2012.00159.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/10/2012] [Accepted: 09/02/2012] [Indexed: 11/28/2022]
Abstract
Müllerian duct anomalies are known to cause infertility and reproductive problems. The true incidence of such abnormalities is not well defined. The most widely accepted method of classification for a Müllerian duct anomaly is the American Society of Reproductive Medicine classification (1988). However, there are some rare anomalies inconsistent with the current classification. Herein, we report a rare case of Müllerian duct anomaly, unilateral ovarian and tubal absence with an arcuate uterus. The failure of the Müllerian ducts to canalize can also lead to the development of a unicornuate uterus and adnexal agenesis. An arcuate uterus indicates incomplete septal absorption after normal fusion of the Müllerian ducts. Therefore, its coexistence with adnexal absence and an arcuate uterus is considered to be extremely unlikely.
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Affiliation(s)
- Yusuke Tanaka
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan
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Bouchlariotou S, Sofia B, Tsikouras P, Panagiotis T, Rösing B, Beniamin R, Neulen J, Josef N. Women with one ovary in assisted reproduction technologies: a review of the literature. Arch Gynecol Obstet 2012; 286:1041-7. [PMID: 22829101 DOI: 10.1007/s00404-012-2477-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 07/12/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND A number of patients who have undergone assisted reproductive technology (ART) have only one ovary. PURPOSE This article reviews the clinical implications of the absence of an ovary on the reproductive potential and the outcome in ART cycle. DATA SOURCES MEDLINE, Pubmed, the Cochrane Controlled Trials Register, and Cochrane Database of Systematic Reviews from the 1980s through April 2010. STUDY SELECTION Randomized, controlled trials; systematic reviews of trials; and observational studies; all restricted to English-language articles. DATA SYNTHESIS This review includes 58 articles. Women with a single ovary did not, in general, respond as well to ovulation induction treatment than women with two ovaries in ART cycles. It appears however, that once women with a single ovary achieve the stage of embryo transfer, they can be reassured that their chances of having a child are the same as women with two ovaries. Whether the right or left ovary responds better to superovulation is a question which remains unanswered in the literature. LIMITATIONS The authors could not address all management questions, and excluded non-English-language literature.
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Affiliation(s)
- Sofia Bouchlariotou
- Laboratory of Reproductive Physiology, University of Aachen, Aachen, Germany
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Vaiarelli A, Luk J, Patrizio P. Ectopic pregnancy after IVF in a patient with unilateral agenesis of the fallopian tube and ovary and with endometriosis: search of the literature for these associations. J Assist Reprod Genet 2012; 29:901-4. [PMID: 22695747 DOI: 10.1007/s10815-012-9819-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 06/05/2012] [Indexed: 10/28/2022] Open
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Rapisarda G, Pappalardo EM, Arancio A, La Greca M. Unilateral ovarian and fallopian tube agenesis. Arch Gynecol Obstet 2009; 280:849-50. [DOI: 10.1007/s00404-009-1018-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Accepted: 02/17/2009] [Indexed: 11/25/2022]
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17
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Unilateral congenital ovarian absence with twisted tube. J Minim Invasive Gynecol 2009; 16:126-7. [PMID: 19249699 DOI: 10.1016/j.jmig.2008.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 07/01/2008] [Accepted: 07/03/2008] [Indexed: 11/22/2022]
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18
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Uckuyu A, Ozcimen EE, Sevinc Ciftci FC. Unilateral congenital ovarian and partial tubal absence: Report of four cases with review of the literature. Fertil Steril 2009; 91:936.e5-8. [DOI: 10.1016/j.fertnstert.2008.09.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 08/30/2008] [Accepted: 09/04/2008] [Indexed: 10/21/2022]
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19
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Sulak O, Cosar F, Malas MA, Cankara N, Cetin E, Tagil SM. Anatomical development of the fetal uterus. Early Hum Dev 2007; 83:395-401. [PMID: 17045762 DOI: 10.1016/j.earlhumdev.2006.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2005] [Revised: 08/16/2006] [Accepted: 08/19/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The objective of this study was to gather data on the morphology of the uterus during its development, to provide detailed information regarding the neighboring structures and its variations using anatomical dissections. STUDY DESIGN Eighty uteri acquired from female fetuses aged 10-40 weeks of gestation were used in this study. Firstly, the relationship between the fetal uterus and the linea terminalis and the position of the uterus within the pelvic cavity was noted. Then the distance between the fundus of the uterus to the promontory and pubic symphysis were measured. Fetal uteri were classified according to their physical appearances. Finally the lengths of the corpus and cervix in three planes and the anteflexion angle were measured. RESULTS During the fetal period, the fundus of the uterus was above the linea terminalis in 94% and below it in 6% of the cases. The distance between the fundus of the uterus and the promontory significantly correlated with the distance between the fundus of the uterus and the pubic symphysis (p<0.001). This was true for the correlation between the gestational age and the orthogonal lengths of the uterine corpus and cervix (p<0.001). As the gestational age advanced, the anteflexion angle was noted to reduce from 177 degrees to 120 degrees . The shape of the uterus was either cylindrical, pear-shaped, heart-shaped or hourglass-shaped during the fetal period. CONDENSATION We believe that the data obtained through dissections of the human fetuses in this study will help identifying uterine developmental variations, anomalies and pathologies and will contribute to the studies carried out in obstetrics, perinatology, forensic medicine and fetal pathology departments.
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Affiliation(s)
- O Sulak
- Suleyman Demirel University, Faculty of Medicine, Department of Anatomy, 32260-Isparta, Turkey.
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20
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Johnston K, Russell P, Shukla A, Reid G, Cooper M. Unilateral pelvic endometriosis and congenital unilateral ovarian agenesis. Pathology 2007; 39:285-7. [PMID: 17454769 DOI: 10.1080/00313020701230690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sulak O, Malas MA, Esen K, Cetin E, Tagil SM. Size and Location of the Fetal Human Ovary. Fetal Diagn Ther 2005; 21:26-33. [PMID: 16354971 DOI: 10.1159/000089044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2004] [Accepted: 11/10/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the development and the localization of the ovaries during the fetal period. MATERIAL AND METHODS One hundred and fifty-four ovaries obtained from 77 human fetuses aged between 9 and 40 weeks of gestation were used in this study. Firstly, the shapes and the positions of the ovaries were established. Second, the localization of the ovaries with respect to linea terminalis, ureters, and the iliac arteries were determined. Finally, the dimensions and the weight of the ovaries were measured. FINDINGS In the fetal period, the ovaries were most commonly almond shaped and had an oblique orientation. In the 1st trimester the midpoint of the long axis of the fetal ovaries were at the level of linea terminalis. In the 2nd and 3rd trimester and full-term fetuses, it was observed that the ovaries were not in ovarian fossa, suggesting that descensus ovary was in progression during these times. During the intrauterine period, the ovaries were most commonly located anterior to the ureters and over the common iliac artery, only to migrate to its final location between the internal and external iliac arteries towards the end of the 40th week. CONCLUSION We found that the ovaries did not assume the position of the adults at the end of the fetal period, rather continued its descent after the birth. We believe our findings about the fetal ovaries will be useful in obstetrics, fetal pathology, and forensic pathology.
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Affiliation(s)
- Osman Sulak
- Department of Anatomy, University of Suleyman Demirel, Faculty of Medicine, Isparta, Turkey.
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Enríquez G, Durán C, Torán N, Piqueras J, Gratacós E, Aso C, Lloret J, Castellote A, Lucaya J. Conservative Versus Surgical Treatment for Complex Neonatal Ovarian Cysts: Outcomes Study. AJR Am J Roentgenol 2005; 185:501-8. [PMID: 16037528 DOI: 10.2214/ajr.185.2.01850501] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Prenatally diagnosed complex ovarian cysts are most often managed surgically in an attempt to save the ovary. Nevertheless, published surgical results disclose that most patients undergo oophorectomy or salpingo-oophorectomy. We assessed whether a surgical or conservative approach was more appropriate by comparing the long-term outcome of infants treated by both methods. A hypothesis for the cause of complex cysts is presented. CONCLUSION Clinical evidence questions the use of surgery for asymptomatic complex ovarian cysts. Histologic analysis suggests gonad maldevelopment as the origin of complex neonatal ovarian cysts.
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Affiliation(s)
- Goya Enríquez
- Pediatric Radiology Department, Hospital Materno-infantil Vall d'Hebron, Ps. Vall d'Hebron 119-129, Barcelona E-08035, Spain.
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23
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Mylonas I, Hansch S, Markmann S, Bolz M, Friese K. Unilateral ovarian agenesis: report of three cases and review of the literature. Arch Gynecol Obstet 2003; 268:57-60. [PMID: 12673478 DOI: 10.1007/s00404-002-0451-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2002] [Accepted: 10/22/2002] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Unilateral ovarian agenesis is a rare event and only a few case have been reported. CASE REPORT We present three additional cases, where patients presented with diffuse lower abdominal pain. During laparoscopy, an unilateral ovarian agenesis was observed in the three cases. DISCUSSION There are two possible explanations of a unilateral ovarian absence, involving an asymptomatic adnexal torsion or congenital absence. Unknown environmental factors or genetic predisposition could contribute to this kind of anomaly.
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Affiliation(s)
- I Mylonas
- Frauenklinik, Klinikum Innenstadt, Ludwig-Maximilians Universität, Munich, Germany
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