title: [Preservation of the fertility and the ovaries in women with benign adnexal tumors].
abstract: OBJECTIVE
  To evaluate the sparing of fertility and ovaries in women submitted to surgical treatment for benign adnexal tumors.
  
  
  METHODS
  Between February 2010 and January 2014, 206 patients were included in this observational study as they were submitted to surgical treatment for benign ovarian tumors at CAISM, a tertiary hospital. Fertility sparing surgery was defined as tumorectomy or unilateral salpingoophorectomy without hysterectomy in premenopausal women. Preservation of the ovary occurred when at least one ovary or part of it was mantained.
  
  
  RESULTS
  Of the 206 women with benign tumors, 120 (58%) were premenopausal and 86 (42%) were postmenopausal. There were 36 (30%) ovarian germ cell tumors, 31 (26%) epithelial neoplasms and 11 (9%) sex-cord stromal tumors among premenopausal women. In the group of postmenopausal women, 35 (41%) epithelial neoplasms, 27 (31%) sex-cord stromal tumors and 8 (9%) ovarian germ cell tumors were identified. Among 36 women with non-neoplastic ovarian tumors, 21 (58%) had endometriomas and 8 (22%) functional cysts. Among 22 women with extra-ovarian tumors, uterine leiomyomatosis was the most frequent finding (50%). In the group of women who were ≤ 35 years old, 26 (57%) were treated by tumorectomy and 18 (39%) were submitted to unilateral salpingoophorectomy with sparing of the uterus and the contralateral ovary. Women who were ≤ 35 years old were more frequently operated by laparoscopy which was associated with a higher number of fertility sparing procedures when compared to laparotomy (p<0.01). Twenty-six (28%) women submitted to hysterectomy with bilateral salpingoophorectomy were premenopausal.
  
  
  CONCLUSIONS
  Although there is a trend to perform only tumorectomy in women who are ≤ 35 years old, a significant number of young women is still treated by salpingoophorectomy. Among 36- to 45-year-old women, only 70% had their fertility spared, while 20% had both ovaries removed. However, whenever possible, we must try to preserve the ovaries, mainly in premenopausal women.
authors.affiliation: Departamento de Ginecologia e Obstetrícia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
authors.forename: Elen
authors.initials: E
authors.lastname: Souza
authors.affiliation: Departamento de Ginecologia e Obstetrícia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: Departamento de Ginecologia e Obstetrícia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
authors.forename: Heloisa
authors.initials: H
authors.lastname: Peres
authors.affiliation: Departamento de Anatomia Patológica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
authors.forename: Liliana de Angelo
authors.initials: Lde A
authors.lastname: Andrade
authors.affiliation: Departamento de Ginecologia e Obstetrícia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
authors.forename: Luis Otávio
authors.initials: LO
authors.lastname: Sarian
authors.affiliation: Departamento de Ginecologia e Obstetrícia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
authors.forename: Sophie
authors.initials: S
authors.lastname: Derchain
mesh_terms: D000328:Adult; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D059351:Organ Sparing Treatments; D010051:Ovarian Neoplasms / Q000601:surgery*; D010052:Ovariectomy; D010053:Ovary; D011446:Prospective Studies