Feasibility of Percutaneous Ultrasound Guided Drainage as a Primary Treatment of Large Functional Ovarian Cysts in Neonates: A Retrospective Analysis.

Background/Purpose: Functional ovarian cysts are commonly detected in neonates. When cysts exceed 5 cm indiameter, there is an increased risk of complications, such as ovarian torsion, intra-cystic hemorrhage and rupture.The standard treatment approach has been surgical often resulting in oophorectomy. Recently, percutaneousultrasound (US)-guided aspiration has emerged as a therapeutic alternative. This study aims to evaluate itsefficacy as a reliable treatment for large functional cysts.Patients and methods: This retrospective study included 15 cases of congenital functional ovarian cysts. Eachcyst was punctured trans-abdominally under general anesthesia. All patients were followed up clinically and byabdomino-pelvic ultrasound after one week. In case of reaccumulating to a diameter more than 50 mm, repeatedaspiration was attempted. Data were analyzed for demographics, lesion characteristics, technical complications,recurrence, ultrasound examination findings on follow up.Results: The average cyst diameter was 65 mm (SD = 1.49 mm) and a range of 50-100 mm. Within two weekspost-procedure, 13.3% (n = 2) of cases resolved completely, while 86.7% (n = 13) experienced reaccumulatingbut below 50 mm in diameter. Only one case needed respiration. By six months of age, all cases (100%) were fullyresolved without any surgical intervention.Conclusion: Percutaneous ultrasound-guided drainage is an effective minimally invasive treatment for largeneonatal functional ovarian cysts, demonstrating a high rate of cure and obviating the need for surgical intervention.