Applying the vaginal approach for benign ovarian cystectomy: current evidence and future applications

Nicolas Galazis; Stephanie Mappouridou; Srdjan Saso; Konstantinos Lathouras; Joseph Yazbek

doi:10.2144/fsoa-2019-0138

Applying the vaginal approach for benign ovarian cystectomy: current evidence and future applications

Future Sci OA. 2020 Apr 15;6(5):FSO470. doi: 10.2144/fsoa-2019-0138.

Authors

Nicolas Galazis¹, Stephanie Mappouridou¹, Srdjan Saso^{1

2}, Konstantinos Lathouras¹, Joseph Yazbek¹

Affiliations

¹ West London Gynaecological Cancer Centre, Queen Charlotte's Hospital, Hammersmith Hospital Campus, Imperial College London, Du Cane Road, London W12 0HS, UK.
² Division of Surgery & Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0HS, UK.

Abstract

Vaginal ovarian cystectomy has not gained wide acceptance owing to the potential difficulty in entering the cul-de-sac. We review the current evidence on vaginal approaches to benign ovarian cysts. Outcome measures of interest included time to return to work, patient satisfaction, surgical complications and length of hospital stay. Ten studies were included in this review and involving 525 patients. Vaginal ovarian cystectomy is overall safe and feasible in appropriately selected cases with no evidence of intrapelvic adhesions or endometriosis. These findings will need to be validated in appropriately powered studies, before reliable conclusions can be drawn. Furthermore, we emphasize the importance of ultrasound both preoperatively for case selection optimization and intraoperatively, as a means of guidance during posterior culdotomy.

Keywords: intraoperative ultrasound; vaginal ovarian cystectomy; vaginal pelvic surgery.

Publication types

Review