ADNEXAL MASSES AND THEIR CORRELATION WITH GYNECOLOGICAL AND GENERAL SURGICAL OUTCOMES

Abstract

Background: Adnexal masses are a heterogenous class of pathological entities seen across all age groups in women and vary in surgical complexity depending on the characteristics of the mass, tissue of origin and histopathology. Many times, general and gynaecological surgical skills are required, as well as surgical skills to manage neighbouring organs, and intrinsic difficulties may be encountered during the procedure. Objective: To determine the incidence and nature of the adnexal masses and their correlation to gynaecological and general surgical outcome among women presenting with adnexal masses in tertiary care hospitals of Pakistan. Study Design: Observational Multi-center Study. Place & Duration: various Tertiary Care Hospitals of Pakistan for 6 months duration from Oct 2025 to  March 2026. Methodology: 120 cases of women with diagnosed adnexal masses were enrolled. According to ultrasonographic and histopathological characteristics, masses were categorised into benign functional, benign neoplastic, borderline and malignant types. Gynaecological outcomes, as well as outcomes from general surgical procedures, were documented. The SPSS version 26.0 software was used for data analysis; Chi-square test and independent samples t-test were used and p<0.05 was set as the level of statistical significance. Results: Benign functional masses were most prevalent (n=57, 47.5%), followed by benign neoplastic (n=39, 32.5%), borderline (n=15, 12.5%), and malignant (n=9, 7.5%). Malignant masses were significantly associated with higher gynaecological complication rates (88.9% vs. 12.3%, p <0.001), bowel involvement (55.6% vs. 1.8%, p <0.001), conversion to open surgery (66.7% vs. 5.3%, p <0.001), and prolonged hospital stay (9.4 ± 3.1 vs. 2.7 ± 1.0 days, p <0.001). A majority of patients (93.0%) who underwent surgery for a benign functional tumor had fertility-sparing surgery while 11.1% had surgery for a malignant tumor (p <0.001). Conclusion: The results showed that histopathology of the adnexal mass shows significant association with both the gynaecological surgery outcome and the general surgical outcome (conclusion). Surgical morbidity is significantly greater with malignant and borderline masses. Preoperative risk stratification and multidisciplinary preoperative planning are very important to improve the surgical outcomes, in resource-limited tertiary care setting.