Laparoscopic detorsion and fertility preservation in twisted ischemic adnexa – A single-center prospective study
Open Access
- 1 January 2020
- journal article
- research article
- Published by Medknow in Gynecology and Minimally Invasive Therapy
- Vol. 9 (1), 24-28
- https://doi.org/10.4103/gmit.gmit_20_19
Abstract
Objective: This study aimed to analyze our experience about the salvageability of ovary in cases of adnexal torsion by laparoscopy, irrespective of the grade of necrosis and number of twists, and to assess the subsequent ovarian viability. Materials and Methods: This is a prospective study conducted in a tertiary care laparoscopic institute. All the cohorts of intraoperative diagnosis of adnexal torsion were included irrespective of the age group from January 2015 to January 2018 over the period of 3 years after obtaining approval from the institute's human ethics committee. Their demographic details and clinical and operative findings were entered after obtaining an informed written consent. All patients underwent laparoscopy except those with a suspicious diagnosis of malignancy. Postoperatively, ovarian viability was assessed by ultrasound Doppler in terms of vascularity and follicular development at 1, 6, and 12 months. Results: A total of 84 patients were included in the study. Acute abdominal pain (71.4%) was the main presenting symptom in all age groups. The total number of cases of adnexal torsion was 69. Adnexal torsion was mainly diagnosed in young and adolescent girls. Out of 46 attempted detorsion, 45 ovaries were preserved (97.8%). Most of the pathologies were benign. All the preserved ovaries were showing follicles and vascularity during ultrasound follow-up. Conclusion: Laparoscopic detorsion of the ovary is the best treatment modality irrespective of the grade of ischemia. Ovarian structure and follicles were preserved following detorsion in all the cases, even in gravely ischemic ovaries.Keywords
This publication has 14 references indexed in Scilit:
- Should the ovary always be conserved in torsion? A tertiary care institute experienceJournal of Pediatric Surgery, 2014
- Adnexal Torsion: Review of the LiteratureJournal of Minimally Invasive Gynecology, 2014
- Ovarian and tubal torsion: imaging findings on US, CT, and MRIEmergency Radiology, 2013
- Management of Isolated Tubal Torsion in a Premenarchal Adolescent Female with Prior Oophoropexy: A Case Report and Review of the LiteratureJournal of Pediatric and Adolescent Gynecology, 2013
- Laparoscopic management of pedicle torsion of adnexal cystsOncology Letters, 2013
- Ovarian torsion: diagnosis of inclusion mandates earlier interventionJournal of Pediatric Surgery, 2012
- Adnexal torsion in children and adolescents: new trends to conservative surgical approach – Our experience and review of literatureGynecological Endocrinology, 2012
- Risk Factors, Symptoms, and Treatment of Ovarian Torsion in Children: The Twelve-Year Experience of One CenterJournal of Minimally Invasive Gynecology, 2012
- Oophoropexy to Prevent Adnexal Torsion: How, When, and for Whom?Journal of Minimally Invasive Gynecology, 2010
- Adnexal TorsionClinical Obstetrics and Gynecology, 2006