Management of adnexal masses: save the ovaries

Background: Adnexal mass is a common presenting complaint in gynaecology. Total 1318 cases were operated over two and a half years (January 2015-June 2017), out of which 195 (14.7%), were for adnexal mass.Methods: To review cases of adnexal masses who underwent surgery over the period of two and a half year in a tertiary care hospital with respect to presentation, aetiology, type of surgeries and fertility preservation.Results: There were totally 195 patients, mostly of age group 26-45 years affected by adnexal mass. Most common presentation was pain abdomen (70 cases i.e. 79.5%). Ectopic pregnancy (115 cases i.e. 58.9%) was the most common diagnosis, followed by ovarian cyst (71 cases i.e. 36.4%). Most cases were treated by open surgery. Laparoscopic management was done for 33 cases (17.9%). Except in unavoidable situations active effort were made to conserve ovaries. Oophorectomy was done in 22 cases (11.2%) and in 173 cases (i.e. 88.8%) fertility preservation was done. Malignancy was seen in 4 (2%), which were managed by open surgery.Conclusions: Ectopic pregnancy was the most common aetiology of adnexal mass, and laparoscopy and its known benefits to patients is the best approach if available. For cases with suspected malignancy, open surgery will remain a safer option