PREOPERATIVE EVALUATION OF OVARIAN-TUMORS IN THE PREMENOPAUSE BY TRANSVAGINOSONOGRAPHY

OBJECTIVE: The aim of the study was to establish reproducible sonomorp hologic criteria by use of transvaginosonography in the preoperative e valuation of ovarian tumors in the premenopause. STUDY DESIGN: In a pr ospective study from 1987 to 1993 we investigated 1072 ovarian tumors; All tumors greater than or equal to 3 cm were included in the study. To avoid unnecessary operations, all tumors we rescanned after 6 weeks . The sonomorphologic criteria were correlated with the histologic fin dings. RESULTS: A total of 4.3% of ovarian tumors in the premenopause were malignant. In the special group of sonographically simple ovarian cysts we found 0.8% malignancies. The incorporation of a control scan after 6 weeks in the management of ovarian cysts reduces the number o f unnecessary operations on functional cysts. Only 5.5% of the functio nal tumors were operated on. The risk for malignancy in cystic-solid o varian tumors is 17.0%, the highest of all sonomorphologic tumor types . CONCLUSIONS: The use of reproducible sonomorphologic criteria in com bination with a control scan in premenopausal women with ovarian cysts proved to be efficient to reduce the number of unnecessary operations and to evaluate the risk for malignancy.