Background: Ovarian tumor and tumor like conditions are seen in women from early childhood to post-menopausal age. The ovaries are a pair of female sex glands responsible for the germ cell maturation, storage and release; cyclically. It also plays an important role in steroidogenesis. The ovaries are a totipotential structure and hence, neoplasms from all 3 germinal layers can be seen arising from it and manifesting clinically as ovarian tumors and tumor like conditions with its occurrence more during the late reproductive life. Ovarian tumors represent about 30% of all cancers of the female genital system. They manifesting in a wide spectrum of clinical, morphological and histological features.Methods: This is retrospective observational study where analysis of all cases which were encountered surgically during the period Mar 2012 to Mar 2017. The cases diagnosed as ovarian tumors were subjected to thorough investigation by CA125, ultrasound (USG) abdomen and pelvis and Computerised Tomography (CT) scan. Emergency presentations with twisted cysts were operated in emergency setting and histopathological examination (HPE) done to identify the nature of tumor. IHC was done wherever necessary to sub classify and confirm the histological diagnosis. Surgeries were done either by conventional laparotomy or by laparoscopy.Results: We have analyzed 175 cases retrospectively after histopathological diagnosis. The commonest lesions were ovarian cysts, out of which 63 cases (36%) were simple serous cyst adenomas followed by mucinous cyst adenomas 30 cases (17.14%). Germ cell tumors with struma ovarii were 34 cases (19.42%). The interesting part of the study was that we had a very high incidence of large endometriomas diagnosed as ovarian cysts before surgery 16 cases (9.4%). Two cases (1.14%) of ovarian malignancy were detected.Conclusions: The above study has revealed a spectrum of ovarian tumors over a wide age range from adolescent to late reproductive to menopausal and late menopausal age group. The incidence of malignancy was (1.14%).
Background: The prevalence of leiomyoma is 30% to70% in reproductive women. In addition to causing menstrual disorders like menorrhagia, mass in abdomen, pain and it also negatively affect fertility and pregnancy outcome. Objectives of present study was to investigate the outcome in cases of pregnancy complicated by fibroids undergoing lower segment cesarean section (LSCS) in DM WIMS Medical College and Hospital, Wayanad, Kerala, where the prevalence of fibroids is high in reproductive women.Methods: Twelve cases of leiomyoma with pregnancy underwent LSCS with myomectomy following the delivery of the baby. The indications for myomectomy during LSCS taken into consideration were firstly the size of fibroids usually less than 5 cm, mainly single myoma complicating pregnancy and sites like sub serous and intramural. The suturing of the uterus was done using polyglycolic acid of size No. 1 and polyglycolic acid suture of 2 ‘0’ for closing the dead space and with good hemostasis the operation was completed. The indications for cesarean, the average operative time for surgery, the amount of blood loss, and postoperative complications like surgical site infections were noted and outcome recorded.Results: The time taken for surgery was about 45 minutes longer, average blood loss was approximately 300 ml to 500 ml more than for a routine LSCS. There was no surgical site infections or postpartum hemorrhage in any of the cases.Conclusions: Myomectomy with caesarean in selected cases with proper indications is safe and possible in selected cases. It avoids a second surgery with its associated morbidity.
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