Clinical profile of patients with pelvic adnexal masses

Suksham Sharma, Ajay K. Wakhloo, Gagan D. Singh
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2018 · vol. 7(11) , pp. 4684 · doi:10.18203/2320-1770.ijrcog20184530 · W2898606804
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This study evaluated the clinical profile of 48 reproductive-age women with adnexal masses, finding that lower abdominal pain was the most common complaint and endometriosis was a frequent suspected diagnosis.

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This study evaluated the clinical presentation and diagnostic characteristics of pelvic adnexal masses in 48 women of reproductive age. The researchers found that lower abdominal pain was the predominant symptom, with chronic pelvic pain being the most frequent complaint among these patients. Clinical examinations allowed for suspicion of specific etiologies, including endometriosis in over 40% of cases, ovarian cysts, and ectopic pregnancies. The authors concluded that thorough preoperative assessment facilitates the selection of appropriate candidates for laparoscopic management. Relevance to endometriosis: listed as one suspected diagnosis in patients with adnexal masses, though the paper's main focus is general adnexal mass evaluation.

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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. Aim was to study the clinical profile of women in reproductive age group presented with adnexal masses.Methods: The study comprised of 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.Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. Out of these, majority i.e.66.67% had chronic pelvic pain and 23% had pain of less than 1-month duration which were cases of ectopic pregnancy. 41.67% cases were suspected to have endometriosis,33.33% were suspected to have ovarian cyst, followed by ectopic pregnancy in 16.67% cases and tubo-ovarian mass in 8.33% cases.Conclusions: The present study shows that if proper preoperative evaluation is done, we 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. Aim was to study the clinical profile of women in reproductive age group presented with adnexal masses.

Methods

The study comprised of 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.

Results

Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. Out of these, majority i.e.66.67% had chronic pelvic pain and 23% had pain of less than 1-month duration which were cases of ectopic pregnancy. 41.67% cases were suspected to have endometriosis,33.33% were suspected to have ovarian cyst, followed by ectopic pregnancy in 16.67% cases and tubo-ovarian mass in 8.33% cases.

Conclusions

The present study shows that if proper preoperative evaluation is done, we can select the appropriate patients for laparoscopic approach. Metrics

References

Brown DL, Dudiak KM, Laing FC. Adnexal masses: US characterization and reporting. Radiol. 2010. ;254(2):342-54. Padilla LA, Radosevich DM, Milad MP. Accuracy of the pelvic examination in detecting adnexal masses. Obstet Gynecol 2000;96(4):593-8. Pejovic T, Nezhat F. Laparoscopic management of adnexal masses: the opportunities and the risks. Ann NY Acad Sci 2001; 943(1):255-68. Terzic MM, Dotlic J, Likic I, Ladjevic N, Brndusic N, Arsenovic N, et al. Current diagnostic approach to patients with adnexal masses: Which tools are relevant in routine praxis? Chin J Cancer Res 2013;25(1):55-62. 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(10):861-6. 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 Endosc. 2013;10:16-8. Saito S, Kajiyama H, Miwa Y, Mizuno M, Kikkawa F, Tanaka S, Okamoto T. 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 Pract Res Clin Obstet Gynaecol. 2000;14(3):467-94. Cunanan RG, Caurey NG, Lippes J. Laparoscopic findings in patients with pelvic pain. Am J Obstet Gynecol 1983;146(5):589-91. Fear RE. Laparoscopy: A valuable aid in gynecologic diagnosis. Obstet Gynecol. 1968; 31(3):297-309. Gupta H, Gupta A, Paul M. Role of Diagnostic Laparoscopy in the Evaluation of Pelvic Adnexal Masses. Int J Innovative Res Development 2015;4(9).

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endometriosischronic_pelvic_pain

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