Ovarian function, reproduction, and later operations following adnexal surgery

Among 3102 patients who had major gynecologic operations, only 223 (7.18%) needed adnexal operations during which reproductive potential was preserved. Operations involved ovaries (156), tubes (55), and embryologic cysts (32). After recovery 53.69% of these patients had viable babies (64.46% of patients under age 30). Patients were examined up to 28 years after operations, an average 11.32 years. When last examined. most patients still retained physiologic evidence of ovarian hormonal function; 20 patients had passed through spontaneous menopause, at an average age of 49.4 years. Fifty-two patients needed subsequent pelvic operations, but only 7 for possibly related conditions (4 repeat tubal pregnancies and 3 cyst-adenomas). All but one twisted adnexal mass, with gangrene, originated as a paramesonephric duct cyst. Seventeen adnexal operations were associated with pregnancy: 15 mothers had healthy babies, and 2 aborted. Details concerning numbers and characteristics of specific lesions are included in the paper.