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Luo PY, Chen X, Cheng L, Ma L, Gou SJ. Anti-glomerular basement membrane disease with rupture of the newly formed bilateral corpus luteum cysts: A case report. Medicine (Baltimore) 2022; 101:e31643. [PMID: 36316838 PMCID: PMC9622636 DOI: 10.1097/md.0000000000031643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Anti-glomerular basement membrane (anti-GBM) disease during gestation is sparse and even rarer when combined with bilateral large corpus luteum cysts. In this case, we report a case of anti-GBM disease in the early stage of pregnancy with ruptured newly formed bilateral large corpus luteum cysts. PATIENT CONCERNS A 24-year-old female was initially diagnosed with anti-GBM disease. During treatment, abdominal distention and vaginal bleeding successively staged. The results of the first gynecological ultrasound and abdominal CT were negative. DIAGNOSIS Based on the dynamic imaging change of the ovaries, the elevated human chorionic gonadotropin (hCG) and sex hormones, and the pathological findings, a diagnosis of anti-GBM disease with rupture of the newly formed bilateral corpus luteum cysts during early pregnancy was considered. INTERVENTIONS The patient was treated with corticosteroids, plasma-exchange along with intensive hemodialysis. Then, to confirm the diagnosis, laparoscopic debulking of bilateral ovarian cysts and curettage were performed. OUTCOMES After treatment, the anti-GBM antibody titer declined and the condition of the patient was still stable 2 months following discharge. LESSONS As clinicians, we should be aware that even if the first imaging tests are negative, the relevant indicators should be reviewed dynamically based on the condition of the patients. Additionally, this case raised the question of whether anti-GBM disease was associated with pregnancy and giant corpus luteum cysts, which needs further investigations.
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Affiliation(s)
- Pei-Yi Luo
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, China
| | - Xia Chen
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Cheng
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, China
| | - Liang Ma
- Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, China
| | - Shen-Ju Gou
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Shen-Ju Gou, Department of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China (e-mail: )
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Tsiampa E, Spartalis E, Tsourouflis G, Dimitroulis D, Nikiteas N. Impact on ovarian reserve after minimally invasive single-port laparoscopic ovarian cystectomy in patients with benign ovarian cysts: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14875. [PMID: 34528357 DOI: 10.1111/ijcp.14875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 09/12/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND/AIM The purpose of this article is to review the published literature on single-port laparoscopic (SPL) ovarian cystectomy and to assess whether the reduced port number affects the ovarian reserve in comparison with the conventional multiport laparoscopic (MPL) ovarian cystectomy. MATERIALS AND METHODS It has been suggested that the most accurate marker of ovarian reserve is the Serum anti-Müllerian hormone (AMH). A review of the current literature was performed based on the preoperative and postoperative AMH after SPL and MPL ovarian cystectomy in adult patients with benign ovarian cysts. RESULTS Ovarian cystectomy causes a non-statistically significant reduction in AMH levels four weeks postoperatively in the SPL group compared to the MPL group [MD = 0.11, 95% CI (-0.01, 0.24), P =0 .07]. Operative time was significantly longer, and blood loss was significantly higher in the SPL group. No difference was reported in terms of major or overall postoperative complications between the two groups. CONCLUSION SPL cystectomy may be offered as a minimally invasive surgical alternative for patients who want to preserve their fertility, at the cost of higher blood loss and longer operative time.
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Affiliation(s)
- Eleni Tsiampa
- 2nd Department of Obstetrics and Gynecology, General & Maternity Hospital Helena Venizelou, Athens, Greece
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Spartalis
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
- 2nd Department of Propaedeutic Surgery, Laiko Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Tsourouflis
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
- 2nd Department of Propaedeutic Surgery, Laiko Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Dimitroulis
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
- 2nd Department of Propaedeutic Surgery, Laiko Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Nikiteas
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
- 2nd Department of Propaedeutic Surgery, Laiko Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Chen Q, Zhu S, Wang D, Chen M, Zhao Y, Zhang Q. Hidden blood loss and its risk factors in patients undergoing conventional laparoscopic surgery and laparoendoscopic single-site surgery for ovarian cystectomy. Int J Gynaecol Obstet 2021; 157:424-430. [PMID: 34328652 DOI: 10.1002/ijgo.13842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/11/2021] [Accepted: 07/28/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To quantify the volume of hidden blood loss (HBL) between conventional laparoscopic surgery (CLS) and laparoendoscopic single-site surgery (LESS) for ovarian cyst and to explore its risk factors. METHODS A total of 310 patients who underwent CLS or LESS were enrolled in this study. The Nadler formula and Gross formula were used to calculate each patient's estimated blood volume and total blood loss, multiple linear regression analysis was applied to identify the risk factors. RESULTS The HBL in LESS was more than in CLS (P = 0.000). Operative time (p = 0.015), pre-hematocrit (P = 0.002), pre-hemoglobin (P = 0.015), and pelvic adhesions (P = 0.037) were positively correlated with HBL in CLS. Intraoperative bleeding (P = 0.026), operative time (P = 0.000), pre-hematocrit (P = 0.042), CA125 (P = 0.047), and cyst volume (P = 0.012) were independent risk factors for HBL in LESS. CONCLUSION A large amount of HBL occurs in ovarian cystectomy surgery and cannot be ignored in clinical work; fully and correctly understanding HBL and exploring its causes can ensure the safety and improve the prognosis of patients.
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Affiliation(s)
- Qiuyu Chen
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital and Yuying, Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Sennan Zhu
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital and Yuying, Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Danhan Wang
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital and Yuying, Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Miaomiao Chen
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital and Yuying, Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu Zhao
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital and Yuying, Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiong Zhang
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital and Yuying, Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Clinical and pathological features of women with adnexal masses admitted as emergency cases to the Gynaecology Department of West Kazakhstan University. MENOPAUSE REVIEW 2019; 18:180-183. [PMID: 31975986 PMCID: PMC6970418 DOI: 10.5114/pm.2019.90377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 10/31/2019] [Indexed: 02/01/2023]
Abstract
Aim of the study To detect the clinical and pathological features of women with adnexal masses (AMs) admitted as emergency cases to the Gynaecology Department of West Kazakhstan University. Material and methods A retrospective analysis of the data of women with AMs admitted as an emergency cases to the Gynaecology Department of West Kazakhstan University. The collected data include: age, age of menarche and age of menopause, presenting symptoms, admission criteria – either self-referral or refereed from another department, ultrasound findings, associated pregnancy, associated pathology of the female genital tract, and post-operative histological results of surgically excised AMs (gold standard). Results 77.04% (245/318) of the studied AMs were found in the reproductive age group. The main causes for surgical intervention for the studied AMs was ruptured ovarian cyst in 27.1% or adnexal torsion in 9.7%. The available histological results of the surgically managed AMs showed the following: functional ovarian cyst in 36.2% (115/318), benign ovarian neoplasms (BONs) in 18.55% (59/318), and borderline malignant ovarian tumours in 0.63% (2/318). 44.34% of the studied AMs were associated with pregnancy, 49.3% with chronic tubo-ovarain diseases such as salpingo-oophoritis, 14.8% with cervical pathology and pelvic inflammatory diseases, 11.3% with uterine leiomyomas, and 4.4% with endometrial hyperplasia. Conclusions AMs were more common in the reproductive age group (77.04%), and 44.34% of the studied AMs were associated with pregnancy. The main causes of surgical intervention for the studied AMs were ruptured ovarian cyst in 27.1% or adnexal torsion in 9.7%.
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Wang D, Liu H, Li D, Qiu L, Dai J, Sun D, Zhang J. Comparison of the impact of single-port laparoscopic and conventional laparoscopic ovarian cystectomy on the ovarian reserve in adult patients with benign ovarian cysts. MINIM INVASIV THER 2019; 29:224-231. [PMID: 31154886 DOI: 10.1080/13645706.2019.1624575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Danying Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Haiyuan Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Dandan Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Ling Qiu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Jianrong Dai
- Department of Obstetrics and Gynecology, Suzhou Municipal Hospital, Suzhou, China
| | - Dawei Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Junji Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
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Conca P, Cafaro G, Savastano S, Coppola A, Cimino E, Tarantino G. Suggestive hypothesis on a case report: Patient presenting with cyclical ovarian cysts coupled to increased cholestatic enzymes. J Obstet Gynaecol Res 2018; 45:477-481. [PMID: 30393940 DOI: 10.1111/jog.13859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 10/14/2018] [Indexed: 11/27/2022]
Abstract
We describe the case of a childbearing-age woman presenting with spontaneous recurrent functional ovarian cysts and, more interestingly, chronic and asymptomatic elevation of cholestatic parameters. The patient showed no history of chronic viral infections, immunological and metabolic disorders, alcohol abuse and environmental toxins exposition. Hepatic ultrasonography and cholangio-pancreatography-magnetic-resonance excluded any morphological and structural abnormalities, while liver biopsy evidenced only minimal and not specific features of inflammation. Cholestasis indices obtained prompt recovery after each cycle of synthetic hormone therapy, implanted to treat functional ovarian cysts. She has continuously experienced the off-therapy asynchronous recurrence of liver laboratory abnormalities and functional ovarian cysts. The favorable effect of the synthetic hormone therapy to obtaining a stable recovery of this unexplained long-lasting cholestatic syndrome could be likely explained by downregulation of an endogenous ovarian overproduction, although estrogen-regulated local intracellular transduction pathways cannot be excluded.
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Affiliation(s)
- Paolo Conca
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Giovanni Cafaro
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Antonio Coppola
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Ernesto Cimino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
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Fouedjio JH, Fouelifack FY, Nnang NA, Mbu RE. [Epidemiological, clinical and therapeutic aspects of supposed benign ovarian tumors at the Central Hospital of Yaoundé]. Pan Afr Med J 2017; 25:207. [PMID: 28270904 PMCID: PMC5326262 DOI: 10.11604/pamj.2016.25.207.9939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/18/2016] [Indexed: 12/04/2022] Open
Abstract
Introduction Les tumeurs ovariennes présumées bénignes (TOPB) constituent l'un des motifs les plus fréquents de consultation gynécologique, et l'une des indications les plus fréquentes en chirurgie gynécologique. Méthodes Nous avons mené une étude descriptive rétrospective dans le service de gynécologie-obstétrique de l'hôpital central de Yaoundé. La durée de l'étude était de 6 mois sur une période 5ans du 1er janvier 2010 au 31 décembre 2014. La population de l'étude était constituée de toutes les patientes opérées pour une tumeur ovarienne présumée bénigne pendant la période de l'étude. Résultats L'âge moyen était de 29,33± 6,83 avec un âge minimum de 20 ans et un âge maximum de 48ans. La tranche d'âge la plus représentée est celle de 21à 25 ans. Le motif de consultation était les douleurs pelviennes 93,90% des cas. Onze patientes avaient une grossesse soit 33,3% de notre population d'étude et 72,70% étaient au premier trimestre de la grossesse. Les TOPB répertoriés dans notre série étaient : la rupture de kyste (36,40%), la torsion d'annexe (27,30%), le volumineux kyste ovarien (21,20%), l'hémorragie intrakystique (15,20%). Le traitement était conservateur chez 26 (78,78%) patientes. Cependant, l'annexectomie a été réalisée chez 5 patientes sur 9 qui ont eu une torsion d'annexe. Conclusion Les TOPB compliquées sont présentes dans notre milieu surtout chez des patientes en âge de procréer. Le diagnostic tardif particulièrement en cas de torsion d'annexe oblige un traitement radical qui est délétère pour le patient. Le traitement chirurgical par laparoscopie est le plus recommandé si le plateau technique le permet car il diminue les risques de complications.
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Affiliation(s)
- Jeanne Hortence Fouedjio
- Unité de Gynécologie et Obstétrique de l'Hôpital Central de Yaoundé Cameroun; Département de Gynécologie et Obstétrique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Yaoundé, Cameroun
| | - Florent Ymele Fouelifack
- Unité de Gynécologie et Obstétrique de l'Hôpital Central de Yaoundé Cameroun; Département de Gynécologie et Obstétrique de l'Institut Supérieur de Technologies Médicales de Nkolondom, Yaoundé, Cameroun
| | | | - Robinson Enow Mbu
- Unité de Gynécologie et Obstétrique de l'Hôpital Central de Yaoundé Cameroun; Département de Gynécologie et Obstétrique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Yaoundé, Cameroun
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Tafazoli M, Fazeli E, Nematy M, Bahri N, Dadgar S. The relationship between functional ovarian cysts and vitamin A, vitamin E, and folate intake. J OBSTET GYNAECOL 2016; 37:205-209. [DOI: 10.1080/01443615.2016.1228622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Mahin Tafazoli
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Fazeli
- Department of Anatomy, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Nematy
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narjes Bahri
- Department of Midwifery, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Salmeh Dadgar
- Department of Obstetrics and Gynaecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Almas I, Nisar-ur-Rehman, Azhar S, Ismail M, Murtaza G, Hussain I. Perception and awareness of patients regarding ovarian cysts in Peshawar, Pakistan: a qualitative approach. Contemp Oncol (Pozn) 2016; 19:487-90. [PMID: 26843848 PMCID: PMC4731457 DOI: 10.5114/wo.2015.56657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 05/07/2014] [Indexed: 11/17/2022] Open
Abstract
AIM OF THE STUDY Women health is one of the key issues in developing countries including Pakistan. To improve the women's quality of life, awareness about health is necessary. The objective of this study is to evaluate the patient's perception regarding ovarian cyst and the awareness of the patients about the symptoms and health management in ovarian cyst. MATERIAL AND METHODS A qualitative approach was used to conduct this study. An interview guide was prepared for the data collection. The interview guide had 29 questions which were asked from the patients. The duration of each interview was about 15-20 minutes and conducted in native language (Urdu) which was then translated to English language for the purpose of documentation. Snowball technique was adopted and the sample size was estimated from the point of saturation. RESULTS All the interviews were conducted in the Gynecology ward of Hayatabad Medical Complex (HMC), Peshawar, Pakistan. Results were thematically analyzed. Thematic content analysis yielded 5 major themes: 1) Irregular menstrual cycle, 2) nausea and vomiting, 3) difficulty in emptying urinary bladder completely, 4) emergency due to severe pain, and 5) Physical works. CONCLUSIONS There is a need of time that patients should be counseled at the time of discharge of the patient from the hospital. This is the right of the patient that they know about their disease and benefits of the successful treatment outcomes. Compliance can only be achieved through the counseling of the patients, resulting good quality of life and less economic burden over the patients.
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Affiliation(s)
- Iffat Almas
- Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, Pakistan
| | - Nisar-ur-Rehman
- Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, Pakistan
| | - Saira Azhar
- Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, Pakistan
| | - Mohammad Ismail
- Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
| | - Ghulam Murtaza
- Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, Pakistan
| | - Izhar Hussain
- Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, Pakistan
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Brun JL, Fritel X, Aubard Y, Borghese B, Bourdel N, Chabbert-Buffet N, Collinet P, Deffieux X, Dubernard G, Huchon C, Kalfa N, Lahlou N, Marret H, Pienkowski C, Sevestre H, Thomassin-Naggara I, Levêque J. Management of presumed benign ovarian tumors: updated French guidelines. Eur J Obstet Gynecol Reprod Biol 2014; 183:52-8. [DOI: 10.1016/j.ejogrb.2014.10.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
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Abstract
These guidelines from the French College of Gynecologists and Obstetricians on the diagnosis and treatment of presumed benign ovarian tumors (PBOT) concern physicians whether gynecologists, obstetricians, surgeons, radiologists, pediatricians, and general practitioners. Vaginal pelvic ultrasound is the first-line imaging examination in case of PBOT in adult women (grade A). In case of pure fluid unilocular mass less than 7 cm size, ultrasound is sufficient to characterize the mass (grade A). MRI is recommended as second-line to explore indeterminate masses or masses greater than 7 cm (grade B). Serum CA125 assay is not recommended as first-line diagnostic in adult women (grade C). Among women with a pure unilocular liquid cyst, hormonal therapy is ineffective (LE1) and is not recommended (grade A). Ultrasound-guided puncture is not recommended (grade B). In adult women without history of cancer, abstention is possible in case of asymptomatic pure unilocular cyst less than 10 cm (grade B). If symptoms develop, laparoscopy is the reference approach for PBOT surgical treatment (grade A). A conservative surgical treatment (cystectomy) should be preferred to oophorectomy in non-menopausal women without previous history of cancer (grade C). In cases of suspected adnexal torsion, laparoscopic surgical exploration is recommended (grade B). Conservative treatment, untwisting without oophorectomy, is recommended for non-menopausal women whatever the estimated duration of the twist and the macroscopic appearance of the ovary (grade B). During pregnancy, expectation is recommended for asymptomatic unilocular liquid masses less than 6 cm (grade C).
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[Clinical practice guidelines: Presumed benign ovarian tumors--aims, methods, and organization]. ACTA ACUST UNITED AC 2013; 42:710-4. [PMID: 24210232 DOI: 10.1016/j.jgyn.2013.09.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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