Background/Purpose: Functional ovarian cysts are commonly detected in neonates. When cysts exceed 5 cm in
diameter, 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, percutaneous
ultrasound (US)-guided aspiration has emerged as a therapeutic alternative. This study aims to evaluate its
efficacy as a reliable treatment for large functional cysts.
Patients and methods: This retrospective study included 15 cases of congenital functional ovarian cysts. Each
cyst was punctured trans-abdominally under general anesthesia. All patients were followed up clinically and by
abdomino-pelvic ultrasound after one week. In case of reaccumulating to a diameter more than 50 mm, repeated
aspiration 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 weeks
post-procedure, 13.3% (n = 2) of cases resolved completely, while 86.7% (n = 13) experienced reaccumulating
but below 50 mm in diameter. Only one case needed respiration. By six months of age, all cases (100%) were fully
resolved without any surgical intervention.
Conclusion: Percutaneous ultrasound-guided drainage is an effective minimally invasive treatment for large
neonatal functional ovarian cysts, demonstrating a high rate of cure and obviating the need for surgical intervention.