Laparoscopic management of adnexal cystic masses in postmenopausal women.

Objective: To evaluate laparoscopic treatment of postmenopausal women with an adnexal cystic mass predicted to be benign.

Methods: Selection criteria were transvaginal sonographic appearance other than a complex cyst and a normal serum CA 125 level. During the period May 1988 to June 1993, 55 women fulfilled the criteria and underwent operative laparoscopy. During the same period, 75 postmenopausal women underwent exploratory laparotomy for an adnexal cystic mass that was complex in appearance or associated with elevated serum CA 125.

Results: Laparoscopic bilateral oophorectomy was performed in all 55 women. All had benign masses (positive predictive value 100%). Malignant tumors were found in 23 of the 75 women undergoing laparotomy (negative predictive value 30.7%). There was no significant difference in size of the tumors between women undergoing laparoscopy or laparotomy.

Conclusion: Because of its safety and efficacy, laparoscopic management is the preferred procedure in postmenopausal women with a non-complex adnexal mass and a normal CA 125 level.