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J Turk Ger Gynecol Assoc. 2019 Aug 28;20(3):165-169. doi: 10.4274/jtgga.galenos.2018.2018.0051. Epub 2018 Jul 31.

Adnexal lesions after hysterectomy: A retrospective observational study

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1
Clinic of Obstetrics and Gynecology, Gynecology and Endoscopic Surgery Unit, University of Health Sciences, Ankara Dr. Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey

Abstract

Objective:

To characterize adnexal lesions detected in patients who had undergone previous hysterectomy with one or both ovaries conserved, and to define the clinical, pathologic, and surgical characteristics of the adnexal lesions in these patients.

Material and Methods:

A retrospective observational study was conducted on patients who had undergone a previous abdominal hysterectomy with one or both adnexa preserved and who had subsequently presented with an adnexal lesion. Characteristics of lesions, operative, and pathologic findings in patients who required a re-operation were noted.

Results:

One hundred thirty-seven patients presented with an adnexal lesion after hysterectomy. Of the 137 patients, 71 (51.8%) had undergone a re-operation (re-operated group), the rest of the patients (n=66, 48.1%) remained on follow-up (follow-up group) in whom the lesion disappeared during follow-up period. Adnexal lesions that were re-operated were significantly larger (p<0.001), more complicated (p=0.04), and had more septations (p=0.01) than in the follow-up group. The origin of the adnexal lesion was confirmed as the ovary in 59 (83%) patients, and as the peritoneum in 8 (11.2%) patients during surgery. All of the adnexal lesions arising after hysterectomy and required a re-operation were confirmed to be benign.

Conclusion:

Almost half of the lesions detected after hysterectomy disappeared during the follow-up period. The adnexal lesions that were re-operated were more symptomatic, larger, and had more complicated lesions. All lesions that were re-operated were found to be benign, mostly originating from the ovary.

KEYWORDS:

Adnexal lesion; adnexal preservation; hysterectomy; re-operation

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