Prevalence, Diagnosis, and Management of Adnexal Mass in Reproductive Age Group

Abstract

Objective: To determine the prevalence of adnexal mass and its management outcomes in
patients of reproductive age group.
Methodology: This cross-sectional descriptive study was conducted on 102 women of
reproductive age (15–49 years) presenting with adnexal mass to the gynecological outpatient and inpatient departments. Detailed history including age, parity, menstrual history, presenting
complaints, and duration of symptoms was recorded. Diagnosis was established through
transvaginal or transabdominal ultrasound, tumor markers (CA-125, AFP, LDH, Beta-hCG), and
histopathological examination where applicable. Management modalities including conservative,
medical, and surgical interventions were documented. Statistical analysis was performed using
SPSS version 26.
Results: Mean patient age was 31.6 ± 8.4 years, with peak prevalence in the 26–35-year group
(38.2%). Ovarian cysts were most common (52.9%), followed by endometriomas (17.6%), tubo-
ovarian abscess (12.7%), ectopic pregnancy (9.8%), and malignancy (6.9%). Pelvic pain (68.6%)
was the leading complaint. CA-125 was elevated in 38.2%, strongly correlating with malignancy
(p<0.001). Surgical intervention was required in 50% of cases, predominantly laparoscopic
cystectomy. Mass size >8 cm (OR=4.2; p<0.001) and elevated CA-125 (OR=3.6; p=0.002) were
independent malignancy indicator.
Conclusion: Ovarian cysts constitute the most prevalent adnexal pathology in reproductive-age
women. Ultrasound with CA-125 provides reliable diagnostic accuracy, while laparoscopic
cystectomy remains the predominant surgical approach. Early diagnosis and timely referral are
critical for favorable outcomes, particularly in differentiating benign from malignant masses.
Keywords: Adnexal mass, ovarian cyst, reproductive age, CA-125, ultrasonography,
laparoscopy, malignancy