10% of women will undergo surgery for an ovarian mass during their lifetime. Accurate diagnosis is crucial to avoid unnecessary surgeries and associated risks. The International

Ovarian Tumour Analysis (IOTA) ultrasound study has sensitivity of 95% and a specificity of 91%. Ultrasound should be the initial diagnostic tool for characterizing ovarian

masses, guiding management decisions between conservative approaches and surgical intervention, thereby reducing unnecessary surgeries and associated risks.

DESIGN

This retrospective audit was conducted at Darent Valley Hospital to evaluate the

accuracy of preoperative ultrasound in diagnosing ovarian cysts and compared

findings to standards from the Getting It Right First Time (GIRFT) national

initiative. The study reviewed patient outcomes to assess the correlation between

pre-operative imaging, surgical findings, and histology.

METHODOLOGY

This audit included 99 patients who underwent ovarian cyst surgery from January to

August 2022. Patient list was provided by theatre administrator. Data was collected

from electronic patient records, including clinic letters, operation notes and histology

reports.

RESULTS

•Of the 99 women, 92 underwent elective surgery and 7 required emergency

surgery.

•Laparoscopic surgery was performed in 89% while 13% required laparotomy.

•85% of patients were discharged within 24 hours post-elective surgery. The

median length of stay for emergency ovarian surgery was 3 days, exceeding the

GIRFT benchmark of 2 days, primariliy due to postoperative pain

•98% of the cases had ultrasound as initial imaging. Additional imaging required

in 22% (MRI) and 7% (CT scan) for complex ovarian cysts identified by ultrasound.

•In 62% operative documentation matched imaging findings (size and septae).

Dermoid cysts showed 66% concordance between ultrasound, operative, and

histological descriptions.

•30% of the patients underwent salpingo-oophorectomy, with 53% of these

women being postmenopausal.