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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(09): 569-576
DOI: 10.1055/s-0040-1714049
Review Article

Practical Recommendations for the Management of Benign Adnexal Masses

Recomendações práticas para o tratamento de massas anexiais benignas
Rodrigo Manieri Rocha 
1   Departament of Gynecology and Obstetrics, Universidade Estadual do Oeste do Paraná, Cascavel, Paraná, PR, Brazil
,
Ionara Diniz Evangelista Santos Barcelos 
1   Departament of Gynecology and Obstetrics, Universidade Estadual do Oeste do Paraná, Cascavel, Paraná, PR, Brazil
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Abstract

Objective To perform a comprehensive review to provide practical recommendations regarding the diagnosis and treatment of benign adnexal masses, as well as information for appropriate consent, regarding possible loss of the ovarian reserve.

Methods A comprehensive review of the literature was performed to identify the most relevant data about this subject.

Results In total, 48 studies addressed the necessary aspects of the review, and we described their epidemiology, diagnoses, treatment options with detailed techniques, and perspectives regarding future fertility.

Conclusions Adnexal masses are extremely common. The application of diagnosis algorithms is mandatory to exclude malignancy. A great number of cases can be managed with surveillance. Surgery, when necessary, should be performed with adequate techniques. However, even in the hands of experienced surgeons, there is a significant decrease in ovarian reserves, especially in cases of endometriomas. There is an evident necessity of studies that focus on the long-term impact on fertility.

Resumo

Objetivo Realizar uma revisão abrangente para fornecer recomendações práticas sobre o diagnóstico e tratamento de massas anexiais benignas, bem como informações para um consentimento adequado com relação à possível perda da reserva ovariana.

Métodos Uma revisão abrangente da literatura foi realizada para identificar os dados mais relevantes sobre o assunto.

Resultados No total, 48 estudos abordaram os aspectos necessários da revisão, e descrevemos sua epidemiologia, diagnósticos, opções de tratamento com técnicas detalhadas, e perspectivas sobre fertilidade futura.

Conclusões As massas anexiais são extremamente comuns. A aplicação de algoritmos de diagnóstico é obrigatória para excluir a malignidade. A maioria dos casos pode ser manejada conservadoramente. A cirurgia, quando necessária, deve ser realizada com técnicas adequadas. No entanto, mesmo nas mãos de cirurgiões experientes, há diminuição significativa da reserva ovariana, principalmente nos casos de endometriomas. Há uma evidente necessidade de estudos que enfoquem o impacto das massas anexiais benignas na fertilidade em longo prazo.

Keywords

adnexal masses - ovarian cysts - ovarian surgery - ovarian reserve - infertility - fertility preservation

Palavras-chave

massas anexiais - cistos ovarianos - cirurgia ovariana - reserva ovariana - infertilidade - preservação da fertilidade


Publication History

Received: 27 April 2019

Accepted: 31 March 2020

Article published online:
19 June 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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