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

Ajay K. Wakhloo, Suksham Sharma, Gagan D. Singh
In: International Journal of Research in Medical Sciences · 2018 · vol. 7(1) , pp. 255 · doi:10.18203/2320-6012.ijrms20185391 · W2906057085
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This study evaluated 48 women and found laparoscopy to be a reliable method for diagnosing and managing benign adnexal masses, with lower abdominal pain being the most frequent complaint.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This study evaluated the role of laparoscopy for diagnosing and managing benign adnexal masses in 48 women of reproductive age, using preoperative clinical assessment (including speculum examination, PAP smear, and bimanual examination) followed by laparoscopy to confirm diagnoses and guide procedures. The most common presenting complaint was lower abdominal pain (87.5%). Preoperative suspicion of endometriosis (41.67%) increased on laparoscopy (47.92%), while suspected ovarian cysts (33.33%) decreased to 25% on laparoscopy, and tubo-ovarian masses declined from 8.33% preoperatively to 2.08% laparoscopically, with ectopic pregnancy remaining at 16.67% by both assessments. The paper does not clearly state histopathologic confirmation methods or long-term outcomes as limitations. Relevance to endometriosis: the study reports how preoperative suspicion of endometriosis among adnexal-mass cases changed after laparoscopy, though the paper’s main focus is the diagnostic and management role of laparoscopy for benign adnexal masses generally.

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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.
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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

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.

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