Laparoscopic Evaluation of Adnexal Masses in Reproductive Age Group
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 7
Abstract
Adnexal masses are one of the most common pathologies among women of all age groups. The aim of the present study was to study laparoscopic diagnosis of adnexal masses in the reproductive age group and to study the spectrum of diverse pathology of adnexal masses in the reproductive age group. Methods: This was a cross-sectional study conducted at Prathima Institute of medical sciences, Karimnagar. 50 subjects between the ages of 18 to 40 years i.e. Reproductive age group were selected for the study, with clinically suspected adnexal masses and ultrasonographically diagnosed adnexal masses. In all cases detailed history was taken and Bimanual pelvic examination was done for assessment of uterine size in weeks, mobility of uterus, size of adnexal mass in cms, characteristics of mass such as surface, mobility and consistency, tenderness, and fullness in fornices and pouch of Douglas, nodules in pod was also noted. Ultrasound preferably trans-vaginal ultrasound was performed in the Department of Radiology in PIMS. Laparoscopy was performed under general anesthesia. The specimen was obtained and sent for histopathological examination and nature of the mass was finally confirmed by histopathological examination. Results: In this study of 50 patients, 68% are in the age group between 21-40 years and only 32% are between 18-20 years 56% were parous ladies and 20% were nulliparous. In the ultrasonography the most common finding was ovarian cyst 36% patients, 18% had torsion ovarian cyst, 18% PCOD, 12% had To mass, on laparoscopy most common finding was ovarian cyst 24% torsion ovarian cyst seen in 18%, endometriotic cyst in 8%, gangrenous ovarian cyst in 4%, dermoid in 2%, tubo-ovarian mass in 8%, Hydrosalpinx in 10%, Fimbrial cyst in 4%, para ovarian cyst in 6%, broad ligament fibroid in 2%, endometriotic nodules found in 4%, adhesions in 20%, free fluid in POD found in 24%. Conclusion: Evaluation of adnexal masses in the reproductive age group is of prime importance and mandatory for appropriate management. Laparoscopy has shown to be the definitive tool for evaluation in surgical management of these masses. Ultrasonography is an adjunct tool which may aid in the diagnosis. Majority of adnexal masses in the reproductive age group are benign in nature.
Authors and Affiliations
Dr. Suguna Maroju, Dr. Rajeshwar Avancha
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