Laparoscopic management of pelvic pain and adnexal masses in adolescent and paediatric patients

M. Candiani, M. Canis, E. Giambelli, A. Natale, V. Baraldini, M. Busacca, M. A. Bruhat, M. Vignali

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Abstract

Objective: To evaluate the role of laparoscopy in paediatric gynaecologic surgery and its usefulness in the diagnosis and treatment of the female child and adolescent presenting with acute or chronic pelvic pain and adnexal masses. Methods: Thirty young women aged 2 to 18 years (mean age, 14.5 years), affected by acute or chronic pelvic pain, underwent diagnostic and operative laparoscopy. In five cases the symptom was not associated with pelvic masses demonstrated at ultrasonography. In twenty-five cases ultrasonography showed an adnexal mass ranging between 4 and 15 cm in diameter. In the group of patients with pelvic pain without pelvic expansive processes the symptomatology was related to the presence of pelvic peritoneal endometriosis, pelvic congestion syndrome and pelvic inflammatory disease. In patients with adnexal masses, 19 underwent operative laparoscopy for enucleation of ovarian cysts. We performed myomectomy, marsupialization of serocele and drainage of tube-ovarian abscesses. Diagnostic laparoscopy was useful to define mullerian anomalies. Four patients underwent emergency operative laparoscopy for acute pelvic pain related to tortion of the adnexa. Results: No major intraoperative complications were encountered. The postoperative course was uneventful in all cases. Mean hospital stay was 2 days. No persistence or recurrence of pelvic pain was recorded over a mean follow-up of 18 months. One case had surgery for contralateral adnexal pathology nine months after our operative laparoscopy. Conclusions: The young age of these female patients makes laparoscopy the procedure of choice in the diagnosis and treatment of pelvic masses and pain. Laparoscopy can offer a correct diagnosis and an immediate treatment: this is important because in this category of patients fertility and endocrine potential should be preserved.

Original languageEnglish
Pages (from-to)82-86
Number of pages5
JournalItalian Journal of Gynaecology and Obstetrics
Volume9
Issue number2
Publication statusPublished - 1997

Keywords

  • Adnexal masses
  • Paediatric laparoscopy
  • Pelvic pain

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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    Candiani, M., Canis, M., Giambelli, E., Natale, A., Baraldini, V., Busacca, M., Bruhat, M. A., & Vignali, M. (1997). Laparoscopic management of pelvic pain and adnexal masses in adolescent and paediatric patients. Italian Journal of Gynaecology and Obstetrics, 9(2), 82-86.