Role of laparoscopy in the diagnosis and management of benign adnexal masses

Ajay Wakhloo; Suksham Sharma; Gagan Singh

doi:10.18203/2320-6012.ijrms20185391

Authors

Ajay Wakhloo Department of Obstetrics and Gynecology, Government Medical College, Jammu, J&K, India
Suksham Sharma Department of Obstetrics and Gynecology, Government Medical College, Jammu, J&K, India
Gagan Singh Department of Obstetrics and Gynecology, Government Medical College, Jammu, J&K, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20185391

Keywords:

Adnexal masses, Clinical examination, Laparoscopy, Pre-operative diagnosis

Abstract

Background: Adnexal masses are frequent findings in women of all age groups. It consists of the ovaries, fallopian tubes and uterine ligaments. Women can present with various gynaecological complaints and adnexal masses could be detected while examining and investigating for these complaints. The aim was to study the role of laparoscopy in diagnosis and management of benign adnexal masses.

Methods: The study was conducted on 48 women of reproductive age group. Per speculum examination was done and PAP smear was taken before bimanual examination was done. A complete per vaginum examination was done and the adnexal mass was assessed for its size, side, consistency, laterality and tenderness. Laparoscopy was done to confirm preoperative diagnosis and appropriate procedure done depending on diagnosis.

Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. 41.67% cases were suspected to have endometriosis while on laparoscopy it was seen in 47.92%, 33.33% were suspected to have ovarian cyst which decreased to 25% on laparoscopy, ectopic pregnancy in 16.67% cases both pre-operative and on laparoscopic examination and tubo-ovarian mass in 8.33% cases pre-operatively and 2.08% on laparoscopy.

Conclusions: This study has shown that if proper preoperative evaluation was done, author can select the appropriate patients for laparoscopic approach.

Metrics

Metrics Loading ...

References

Padilla LA, Radosevich DM, Milad MP. Accuracy of the pelvic examination in detecting adnexal masses. Obs Gynecol. 2000;96(4):593-8.

Pejovic T, Nezhat F. Laparoscopic management of adnexal masses. Ann New York Acad Sci. 2001;943(1):255-68.

DiSaia PJ. The adnexal mass and early ovarian cancer. Clin Gynecol Oncol. 1997:253-81.

Eriksson L, Kjellgren O, von Schoultz B. Functional cyst or ovarian cancer: histopathological findings during 1year of surgery. Gynecol Obs Investigation. 1985;19(3):155-9.

Koonings PP, Campbell KE, Mishell JD, Grimes DA. Relative frequency of primary ovarian neoplasms: a 10-years review. Obs Gynecol. 1989;74(6):921-6.

Parker WH. Management of adnexal masses by operative laparoscopy. Selection criteria. J Repro Med. 1992;37(7):603-6.

Dotlić J, Terzić M, Likić I, Atanacković J, Lađević N. Evaluation of adnexal masses: correlation between clinical, ultrasound and histopathological findings. Vojnosanitetski Pregled. 2011;68:861-6.

Marana R, Caruana P, Muzii L, Catalano GF, Mancuso S. Operative laparoscopy for ovarian cysts. Excision vs. aspiration. J Repro Med. 1996;41(6):435-8.

Reich H. Laparoscopic oophorectomy and salpingo-oophorectomy in the treatment of benign tubo-ovarian disease. Inter J Fertility. 1987;32(3):233-6.

Murphy AA, Nager CW, Wujek JJ, Kettel LM, Torp VA, Chin HG. Operative laparoscopy versus laparotomy for the management of ectopic pregnancy: a prospective trial. Fertility Sterility. 1992 Jun 1;57(6):1180-5.

Medeiros LR, Stein AT, Fachel J, Garry R, Furness S. Laparoscopy versus laparotomy for benign ovarian tumor: a systematic review and meta‐analysis. Inter J Gynecol Cancer. 2008;18:387-99.

Barla J, Yadav R, Agrawal S, RS S, Shukla S. A study to assess the feasibility and safety of laparoscopy in the management of benign adnexal masses. Ind J Gynaecol Endoscopy. 2013;10:16-8.

Saito S, Kajiyama H, Miwa Y, Mizuno M, Kikkawa F, Tanaka S, et al. Unexpected ovarian malignancy found after laparoscopic surgery in patients with adnexal masses-a single institutional experience. Nagoya J Med Sci. 2014;76(1-2):83.

Howard FM. The role of laparoscopy as a diagnostic tool in chronic pelvic pain. Best Prac Res Clin Obs Gynaecol. 2000;14(3):467-94.

Gupta H, Gupta A, Paul M. Role of diagnostic laparoscopy in the evaluation of pelvic adnexal masses. Inter J Innovative Res Development. 2015;4(9).

Yuen PM, Yu KM, Yip SK, Lau WC, Rogers MS, Chang A. A randomized prospective study of laparoscopy and laparotomy in the management of benign ovarian masses. Am J Obstetrics Gynecol. 1997;177(1):109-14.