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P332 The role of routine ultrasound in assistance of postmenopausal women with emphasis on adnexal mass
P332
P333
THE ROLE OF ROUTINE ULTRASOUND IN ASSISTANCE OF POST~ENOPAUS~ WORN WITH E~~rS ON ADNEXAL MASS
SCREENING
A0 Pedro: AM Pinto Neto; LHS Costa Paiva; SFC Zabaglia; JR Salims; DCL Masetto; Ff Dan&s. Menopause Clinic of State University of Campinas, Brazil. The objective of this study was to evaluate routine ul~o~d scans of postmenopausal women who attended the Menopause Clinic of State University of Campinas. A total of 846 ultrasound scans were performed during the year of 1994 and 46,1% of them showed some kind of abno~~iti~ like: myomatosis (14,0%), endome~al thickness (4,00/o), absence of uterus and/or ovaries (23,4%), adnexal mass (8,0%). From the total of patients with adnexal mass, 51 could be evaluated according to the following variables: age, menopause age, reproductive factors, HRT use, previous gynecological surgeries, familial factors for ovarian cancer, ultrasonographic characteristic of adnexal mass and ul~~o~d follow up. Ultrasound scans of these patients showed that 92,2% were simple cysts and 7,8% showed separated cysts and solid or complex mass. Of these patients, eleven unde~~t to surgical exploration due adnexal mass characteristic (septation, solid or complex mass) or due to size (bigger than 5 cm), and only one patient with complex adnexal mass exhibited malignant neoplasm, In the remained 40 patients, serial sonographic surveillance was performed from 1 to 24 months (mean=12 months). In the following ultrasound scans, 29 showed disappearance of the adnexal mass and 11 remained at the same size and characteristic. Therefore, serial ultrasound scan may play a role in the clinical management of postmenopausal women with the objective of diagnose gynecological pathologies and to follow up simple adnexal cysts wi~out surgery.
P334 MYOMA UTERI SIGNIFICANTLY DELAYS THE AGE AT MENOPAUSE T Tamada, Department of Obstetrics and Gynecology, Jichi Medical School, Min~i~w~hi, Tochigi, 329-04 Japan. Although various factors were reported as the factor which delays the age at menopause, few were generalIy accepted except smoking. In the study for the age at menopause conducted with 1856 women aged 35-59 years, attending gynecologic clinics, the median age at menopause was 5 1.30 years, when the 202 women with myo~ of the uterus were included, while that was 50.54 years when the women with myoma was excluded. Occurrence of menopause was significantly higher in the women wi~out myoma of the uterus than that of those with myoma of the uterus, when compared in each age group (5 years interval). The odds ratio adjusted for age was 9.41 (95% ~on~denti~ interval = 5.09 - 17.4).
219
OF ASYMPTOMATIC POST ~NOPAUSAL
OVARIAN, WOMEN
MASSES IN
A. B.Sener, E. Kus p, N. C.Sef kin, G. dzaksit, 0. Glikmen E. Ekici, H. celikkanat Dr.Zekai Tahir Burak Women’s Hospitat Menopause Department, D&&o1 0623Ol~~Y From January 1992 to January 1994,200O women were ~rni~~ at Dr.Zekai Tahir Burak Women’s Hospital Menopause Department. All patients were underwent routine transvaginal ultrasonographic (TVU) evaluation. Out of these, in 8 (0.4%) cases unilateral and larger than 3cm. in diameter ovarian masses were detected. All patients were asymptomatic and with no known history of pelvic tumor. In TVU, five cases were cystic, two were solid and one was semisolid. Serum Cancer Antigen 125 (CA-125) values and transvaginal doppler sonography were provided in patients with ovarian masses. In one case Ca-125 value was greater than normal range (>35IUiLt.). In all cases doppter sono~~hy resistance index (RI) was >0.40. Explorative laparatomy was provided in all patients because of their age. The histopathoiogic examination showed five simple ovarian cysts, one mature cystic teratom~ one thecoma and one mutinous cyst adenocarcinoma. In this study asymptomatic post menopausal women were screened by TVU in case of ovarian masses. The prevalence of ovarian neoplasm and primary ovarian cancer in ~~ptomatic post menopausal patients were found to be 0.4% and 0.05% respectively.
P333
THE ROLE OF ROUTINE ULTRASOUND IN ASSISTANCE OF POST~ENOPAUS~ WORN WITH E~~rS ON ADNEXAL MASS
SCREENING
A0 Pedro: AM Pinto Neto; LHS Costa Paiva; SFC Zabaglia; JR Salims; DCL Masetto; Ff Dan&s. Menopause Clinic of State University of Campinas, Brazil. The objective of this study was to evaluate routine ul~o~d scans of postmenopausal women who attended the Menopause Clinic of State University of Campinas. A total of 846 ultrasound scans were performed during the year of 1994 and 46,1% of them showed some kind of abno~~iti~ like: myomatosis (14,0%), endome~al thickness (4,00/o), absence of uterus and/or ovaries (23,4%), adnexal mass (8,0%). From the total of patients with adnexal mass, 51 could be evaluated according to the following variables: age, menopause age, reproductive factors, HRT use, previous gynecological surgeries, familial factors for ovarian cancer, ultrasonographic characteristic of adnexal mass and ul~~o~d follow up. Ultrasound scans of these patients showed that 92,2% were simple cysts and 7,8% showed separated cysts and solid or complex mass. Of these patients, eleven unde~~t to surgical exploration due adnexal mass characteristic (septation, solid or complex mass) or due to size (bigger than 5 cm), and only one patient with complex adnexal mass exhibited malignant neoplasm, In the remained 40 patients, serial sonographic surveillance was performed from 1 to 24 months (mean=12 months). In the following ultrasound scans, 29 showed disappearance of the adnexal mass and 11 remained at the same size and characteristic. Therefore, serial ultrasound scan may play a role in the clinical management of postmenopausal women with the objective of diagnose gynecological pathologies and to follow up simple adnexal cysts wi~out surgery.
P334 MYOMA UTERI SIGNIFICANTLY DELAYS THE AGE AT MENOPAUSE T Tamada, Department of Obstetrics and Gynecology, Jichi Medical School, Min~i~w~hi, Tochigi, 329-04 Japan. Although various factors were reported as the factor which delays the age at menopause, few were generalIy accepted except smoking. In the study for the age at menopause conducted with 1856 women aged 35-59 years, attending gynecologic clinics, the median age at menopause was 5 1.30 years, when the 202 women with myo~ of the uterus were included, while that was 50.54 years when the women with myoma was excluded. Occurrence of menopause was significantly higher in the women wi~out myoma of the uterus than that of those with myoma of the uterus, when compared in each age group (5 years interval). The odds ratio adjusted for age was 9.41 (95% ~on~denti~ interval = 5.09 - 17.4).
219
OF ASYMPTOMATIC POST ~NOPAUSAL
OVARIAN, WOMEN
MASSES IN
A. B.Sener, E. Kus p, N. C.Sef kin, G. dzaksit, 0. Glikmen E. Ekici, H. celikkanat Dr.Zekai Tahir Burak Women’s Hospitat Menopause Department, D&&o1 0623Ol~~Y From January 1992 to January 1994,200O women were ~rni~~ at Dr.Zekai Tahir Burak Women’s Hospital Menopause Department. All patients were underwent routine transvaginal ultrasonographic (TVU) evaluation. Out of these, in 8 (0.4%) cases unilateral and larger than 3cm. in diameter ovarian masses were detected. All patients were asymptomatic and with no known history of pelvic tumor. In TVU, five cases were cystic, two were solid and one was semisolid. Serum Cancer Antigen 125 (CA-125) values and transvaginal doppler sonography were provided in patients with ovarian masses. In one case Ca-125 value was greater than normal range (>35IUiLt.). In all cases doppter sono~~hy resistance index (RI) was >0.40. Explorative laparatomy was provided in all patients because of their age. The histopathoiogic examination showed five simple ovarian cysts, one mature cystic teratom~ one thecoma and one mutinous cyst adenocarcinoma. In this study asymptomatic post menopausal women were screened by TVU in case of ovarian masses. The prevalence of ovarian neoplasm and primary ovarian cancer in ~~ptomatic post menopausal patients were found to be 0.4% and 0.05% respectively.