DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175277

Management of adnexal masses: save the ovaries

Chitra Champawat, Reena Jatin Wani

Abstract


Background: Adnexal mass is a common presenting complaint in gynaecology. Total 1318 cases were operated over two and a half years (January 2015-June 2017), out of which 195 (14.7%), were for adnexal mass.

Methods: To review cases of adnexal masses who underwent surgery over the period of two and a half year in a tertiary care hospital with respect to presentation, aetiology, type of surgeries and fertility preservation.

Results: There were totally 195 patients, mostly of age group 26-45 years affected by adnexal mass. Most common presentation was pain abdomen (70 cases i.e. 79.5%). Ectopic pregnancy (115 cases i.e. 58.9%) was the most common diagnosis, followed by ovarian cyst (71 cases i.e. 36.4%). Most cases were treated by open surgery. Laparoscopic management was done for 33 cases (17.9%). Except in unavoidable situations active effort were made to conserve ovaries. Oophorectomy was done in 22 cases (11.2%) and in 173 cases (i.e. 88.8%) fertility preservation was done. Malignancy was seen in 4 (2%), which were managed by open surgery.

Conclusions: Ectopic pregnancy was the most common aetiology of adnexal mass, and laparoscopy and its known benefits to patients is the best approach if available. For cases with suspected malignancy, open surgery will remain a safer option.


Keywords


Adnexal masses, Laparoscopy, Save ovaries

Full Text:

PDF

References


Pejovic T, Nezhat F. Laparoscopic management of adnexal masses: the opportunities and the risks. Ann NY Acad Sci. 2001;943:255-68.

Padilla LA, Radosevich DM, Milad MP. Accuracy of the pelvic examination in detecting adnexal masses. Obstet Gynecol. 2000;96:593-8.

Medeiros LR, Rosa DD, Bozzetti MC, Fachel MG, Furness S, Garry R, et al. Laparoscopy versus laparotomy for benign ovarian tumours. Cochrane Database Syst Rev. 2005;20(3):CD004751.

Deckardt R, Saks M, Graeff H. Comparison of minimally invasive surgery and laparotomy in the treatment of adnexal masses. J Am Assoc Gynecol Laparosc. 1994;1:338-9.

Stenchever MA. Comprehensive gynecology. 4th ed. St. Louis, Mo. Mosby; 2001.

Goff BA, Mandel L, Muntz HG, Meancon CH. Ovarian carcinoma diagnosis. Cancer. 2000:89(10):2068-75.

Friedman GD, Skilling JS, Udaltsova NV, Smith LH. Early symptoms of ovarian cancer: a case-control study without recall bias. Fam Pract. 2005:22(5):548-53.

Semm K, Mettler L. Technical progress in pelvic surgery via operative laparoscopy. Am J Obstet Gynecol. 1980;138:121-7.

Tsafrir Z, Hasson J, Levin I, Solomon E, Lessing JB, Azem F. Adnexal torsion: cystectomy and ovarian fixation are equally important in preventing recurrence. Eur J Obstet Gynecol Reprod Biol. 2012;162(2):203-5.