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At least 775 records · Page 43Linked to original sources
PubMed1999

Preoperative ultrasound assessment of adnexal masses in premenopausal women.

OBJECTIVES: This study was undertaken to determine the accuracy of preoperative transvaginal ultrasound in predicting ovarian histopathology in premenopausal women. METHODS: A retrospective cohort study was performed from reproductive-age women that underwent removal of an ovarian cyst between May 1990 and April 1998. RESULTS: Of the 120 consecutive patients identified, 19 did not meet inclusion criteria. Pathologic diagnosis confirmed endometriomas (n = 55), mature teratoma (n = 25), serous cystadenoma (n = 18), persistent corpus luteum (n = 7) and other (n = 5). The primary preoperative transvaginal ultrasound impression was accurate in most cases (endometrioma: 85%, mature teratoma: 86%, serous cystadenoma: 80%). CONCLUSION: Endometriomas and mature cystic teratomas can be predicted with a moderate degree of accuracy by preoperative ultrasound.

Adnexal Diseases↗
PubMed2003

Diphenhydramine and hyaluronic acid derivatives reduce adnexal adhesions and prevent tubal obstructions in rats.

OBJECTIVE: The purpose of this study is to investigate the effects of diphenhydramine-HCl and Na-hyaluronate derivatives on the development of postoperative peritoneal adhesion and tubal obstruction. STUDY DESIGN: Forty female rats of Sprague-Dawley type were used in the study. The rats were divided into four groups, each comprising 10 subjects. After all the rats were anaesthetized with 50mg/kg ketamine HCl, their abdomens were opened with a lower midline incision. Injury was induced on the right pelvic peritoneum and on the peritoneal surface of left uterine tube. No additional procedure was applied to the first group. 10 mg/kg diphenhydramine-HCl was given to the second group intravenously. In the third group, 0.25 mg/kg Orthovisc, a Na-hyaluronate derivative was diluted with 2 ml physiological saline and poured into the abdomen. For the fourth group, Seprafilm, a Na-hyaluronate derivative was covered in a layer of 0.7 cm x 3 cm over the left uterine tube. After 14 days, the rats were anaesthetized with ketamine HCl again, and 5 cm(3) blood sample was taken with cardiac puncture. The abdomen was opened with an incision transverse to the upper end of the midline incision, and the presence of adhesions was investigated. Detected adhesions were staged according to the Mazuji classification. Tubal patencies were inspected by injecting methylene blue from the uterine corpus into the lumen using an injector. A piece of abdominal wall of 4 cm x 4 cm was removed by extending the incision in the reverse U shape. The tensile strength and bursting pressure of the suture line were determined using the Peacock method. One gram of tissue was taken from the incision line, and hydroxyproline levels were determined by the Bergman-Loxley method. Aspartate aminotransferase (AST) levels were measured. RESULTS: All of the rats completed the study. AST levels, tissue hydroxyproline levels and tensile strength and bursting pressure test results were found to be similar in all groups. While adhesion rates in the groups were 100, 40, 40 and 30%, respectively, adhesion stages were found to be, respectively as 2.1+/-1.7, 0.6+/-0.67, 0.6+/-0.67 and 0.5+/-0.85. Adhesion stages in the study groups were significantly lower (P<0.05). Tubal obstruction rates were found to be 70, 30, 30 and 20%, respectively. CONCLUSION: Diphenhydramine, Orthovisc and Seprafilm significantly reduce postoperative peritoneal adhesion development, and they allow the uterine tubes to remain open.

Adnexal Diseases↗
PubMed1997

[Adnexal torsion in children: plea for early laparoscopic diagnosis and treatment].

BACKGROUND: Experience with adnexa torsion in children, a rare but potentially severe pathology, is still disappointing despite constant radiological progress. PATIENTS AND METHODS: The files of 19 patients with adnexial torsion treated between 1985 and 1995 were retrospectively reviewed and compared to those reported. RESULTS: Eight adnexectomies, six oophorectomies, five detorsions with cystectomy and one salpingectomy were performed. There were only five salvaged adnexa in this series. Three tumors were found; all other cases, except three, were torsions induced by voluminous functional cysts. DISCUSSION AND CONCLUSION: Clinical context (sudden right pelvic pain without fever) seems important to note. Sonographic examination is first necessary, but its results are not accurate enough to confirm the torsion. Endo-rectal ultrasonography should become the best diagnostic method in cases of complicated ovaries. In order to increase the percentage of salvaged adnexa, the authors recommend a laparoscopic approach in emergency when clinical examination was doubtful.

Adnexal Diseases↗
PubMed2000

Conservative management of adnexal torsion in premenarchal girls.

STUDY OBJECTIVE: To evaluate treatment of premenarchal girls with torsion of the adnexa. DESIGN: Retrospective review of medical records (Canadian Task Force classification II-2). SETTING: Tertiary care, university-affiliated hospital. PATIENTS: Eight premenarchal girls (age range 3-12 yrs) with twisted adnexa. INTERVENTION: Laparoscopic detorsion and follow-up with B scan and Doppler ultrasound imaging. MEASUREMENTS AND MAIN RESULTS: Duration of complaints ranged from 8 to 72 hours (mean 34.6 hrs) and the interval from admission to surgery ranged from 6 to 24 hours (mean 18.7 hrs). Four patients had torsion of normal-appearing adnexa. The other four had ovarian neoplasms. Two had cystic mature teratomas (dermoid cysts) and one a serous cystadenoma that required additional operation. The fourth girl had a simple ovarian cyst that was aspirated laparoscopically. Seven girls (87%) had normal-appearing ovaries on follow-up ultrasound. In one patient, a small ovary was seen, with no intraovarian blood flow on color Doppler. CONCLUSION: Although the diagnosis of torsion of the adnexa in premenarchal girls is difficult and usually delayed, laparoscopic detorsion seems to be an effective adnexa-sparing approach. We suggest that laparoscopy should be the treatment of choice and that detorsion, rather than adnexectomy, be performed more often in these patients.

Adnexal Diseases↗