Preface

Pediatric surgeons frequently encounter abnormalities of the ovaries and fallopian tubes in girls of all ages. This issue of Seminars in Pediatric Surgery concerns a wide variety of ovarian and adnexal disorders, addressing topics that speak for an evolution of change in treatment. For example, sophisticated radiographic techniques have allowed us to track the natural history of simple ovarian cysts at all ages, including those that are seen prenatally. Since many simple cysts will resolve spontaneously, intervention is now reserved for specific indications. In the arena of ovarian tumors, the fact that most tumors are benign has led to better definition of the elements of malignancy both radiographically and at surgery, enabling ovarian preservation when there are no clear indications for oophorectomy. Treatment options for ovarian malignancies have become more conservative and focused to optimize future fertility and minimize the risk of side effects from adjuvant therapy. Ovarian preservation is also the rule rather than the exception in ovarian torsion, despite the appearance of the ovary following detorsion. Additional topics reviewed include polycystic ovary syndrome, which can be recognized in adolescents and is the most common cause of future infertility in women. There is a discussion of the abnormal gonad, including issues related to gender assignment, and whether to leave a suspected abnormal gonad in situ or remove it and when. We also address the most appropriate treatment of the incidentally found ovarian mass, whether discovered radiographically or at operation.We trust that this issue will better acquaint pediatric surgeons with the current status of treatment options available involving reproductive tract disturbances of the ovary and fallopian tube.