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[Adnexal masses in the Surgical Clinic of the University Hospital Center of Dakar, 74 cases].

The aim of this study was to assesss epidemiological, clinical and the therapeutic aspects of annexial masses. We have performed a retrospective study from 15/09/1994 up to 31/12/1997 including 74 patients. The prevalence rate was 18.40% of the overall gynecologic surgery in our department. Mean age was 36 years old. The range 30-41 years represented 40.5% of our cases. The mean gestity was 4 and the average parity 4. The most common clinical features were pelvic pains (75.57%) and hypogastric masses (50%). The duration of the disease ranged from 1 to 10 years. The general status was good in 94.59% of cases, bad with ascites in 5.41%. The annexial masses were cystic in 87.83%. The ovarian cysts were located at the both sides in 45.94, and bilateral in 8.10%. The annexial masses were solid in 9.45%. An abscess was found in 6.75%. We have performed an annexectomy in 66.1% and a cystectomy in 16.21%. The post operative complications were wound suppuration in 13.51%. The mortality rate was 1.35%. At the long-term follow up we have noticed an eventration in 1.35% and a recurrence with need of reintervention in 16.21%. The pathologic exam found a benign tumor in 95.16% and a carcinoma in 4.84%. The annexial masses are very common in our practice. They involve young multipare women. The main clinical outcome is pelvic pains. Annexectomy is the principal treatment.

Academic Medical Centers↗

[Minimal invasive treatment of the adnexal surgical pathology].

Laparoscopic approach has become the "golden standard" in managing a wide range of adnexial sufferings. Most laparoscopic cases allow patients to recover quickly. Conventional ultrasonography appears to be useful in the preoperative selection for this surgery. Conventional pulsed Doppler and colour Doppler sonography proved their importance in the diagnosis of malignancy. The aim of the study is to evaluate the advantages and the limits of the minimal invasive approach in managing surgical adnexial sufferings. A retrospective study was carried on 75 operative laparoscopy cases performed between 1998-2002. Surgical procedures were performed mainly for ovarian cysts (69 cases, 92%), but there were also treated other types of adnexial pathology such as: hydrosalpinx (2), piosalpinx (1), tubal cysts (2), ectopic pregnancy (7), pelvic adherences (7) and one case of hydatid tubal cyst. Types of surgery performed were cystectomy (36), ooforectomy (11), salpingo-ooforectomy (10), fenestration (10), salpingectomy (6), lysis of adhesions (7). The mean operation time ranged between 50 and 80 minutes and the mean postoperative stay was of 3.65 days.

Adnexal Diseases↗