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Adnexal lesions after hysterectomy: A retrospective observational study.

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


MATERIAL AND METHODS
A retrospective observational study 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 pathological 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 which were re-operated were significantly larger (p<0.001), more complicated (p=0.04), and had more septations (p=0.01) than the follow-up group. The origin of the adnexal lesion was confirmed as the ovary in 59 (83%) of patients, and as the peritoneum in 8 (11.2%) of patients during the operation. 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 follow-up period. The adnexal lesions which were re-operated were more symptomatic, larger, and more complicated lesions. All lesions which were re-operated were found to be benign, mostly originating from the ovary.