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Management and outcomes of adnexal torsion: a 5-year experience

  • General Gynecology
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Abstract

Purpose

To discuss the surgical results of patients with diagnosis of adnexal torsion.

Methods

One hundred and fifty patients with diagnosis of adnexal torsion who presented to our clinic between January 2005 and December 2009 were included in this retrospective analysis. Data regarding age, gravidity, parity, size of mass, operation time, and duration of hospitalization were recorded and compared between the patients who had laparoscopy to those who had laparotomy. The pathological results of patients were also recorded.

Results

Fifty-eight patients were treated laparoscopically while 92 patients had laparotomy. The most frequent presenting symptom was pelvic pain (96%). Laparoscopy group consisted of young patients with low parity; operation and hospital stay time was shorter in laparoscopy group. Velocity loss in Doppler ultrasonography was noted in 81.3% of the patients. Of the laparotomy group 35 postmenopausal patients had hysterectomy and bilateral salpingo-oopherectomy, and staging surgery was done for 16 of them. The pathological finding was found to be malignant in four and borderline serous tumor in four patients.

Conclusion

Laparoscopy is preferred for young patients who want to preserve their fertility. Because of high risk of malignancy in postmenopausal ovarian masses presenting with torsion; frozen section should be used. If not possible or not conclusive, staging surgery is more appropriate especially if there is suspicion of malignancy.

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References

  1. Houry D, Abbott JT (2001) Ovarian torsion: a fifteen-year review. Ann Emerg Med 38:156–159

    Article  PubMed  CAS  Google Scholar 

  2. Comerci JT Jr, Licciardi F, Bergh PA, Gregori C, Breen JL (1994) Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol 84:22–28

    PubMed  Google Scholar 

  3. Cass DL (2005) Ovarian torsion. Semin Pediatr Surg 14:86–92

    Article  PubMed  Google Scholar 

  4. Cohen SB, Oelsner G, Seidman DS, Admon D, Mashiach S, Goldenberg M (1999) Laparoscopic detorsion allows sparing of the twisted ischemic adnexa. J Am Assoc Gynecol Laparosc 6:139–143

    Article  PubMed  CAS  Google Scholar 

  5. White M, Stella J (2005) Ovarian torsion: 10-year perspective. Emerg Med Australas 17:231–237

    Article  PubMed  Google Scholar 

  6. Koonings PP, Grimes DA (1989) Adnexal torsion in postmenopausal women. Obstet Gynecol 73:11–12

    PubMed  CAS  Google Scholar 

  7. Hibbard LT (1985) Adnexal torsion. Am J Obstet Gynecol 152:456–461

    PubMed  CAS  Google Scholar 

  8. Lee EJ, Kwon HC, Joo HJ, Suh JH, Fleischer AC (1998) Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med 17:83–89

    PubMed  CAS  Google Scholar 

  9. Graif M, Itzchak Y (1988) Sonographic evaluation of ovarian torsion in childhood and adolescence. AJR Am J Roentgenol 150:647–649

    PubMed  CAS  Google Scholar 

  10. Descargues G, Tinlot-Mauger F, Gravier A, Lemoine JP, Marpeau L (2001) Adnexal torsion: a report on forty-five cases. Eur J Obstet Gynecol Reprod Biol 98:91–96

    Article  PubMed  CAS  Google Scholar 

  11. Morice P, Louis-Sylvestre C, Chapron C, Dubuisson JB (1997) Laparoscopy for adnexal torsion in pregnant women. J Reprod Med 42:435–439

    PubMed  CAS  Google Scholar 

  12. Cohen SB, Wattiez A, Seidman DS, Goldenberg M, Admon D, Mashiach S, Oelsner G (2003) Laparoscopy versus laparotomy for detorsion and sparing of twisted ischemic adnexa. JSLS 7:295–299

    PubMed  Google Scholar 

  13. Lo LM, Chang SD, Horng SG, Yang TY, Lee CL, Liang CC (2008) Laparoscopy versus laparotomy for surgical intervention of ovarian torsion. J Obstet Gynaecol Res 34:1020–1025

    PubMed  Google Scholar 

  14. Oelsner G, Cohen SB, Soriano D, Admon D, Mashiach S, Carp H (2003) Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Hum Reprod 18:2599–2602

    Article  PubMed  Google Scholar 

  15. Bayer AI, Wiskind AK (1994) Adnexal torsion: can the adnexa be saved? Am J Obstet Gynecol 171:1506–1510 (discussion 1510–1)

    PubMed  CAS  Google Scholar 

  16. Lee RA, Welch JS (1967) Torsion of the uterine adnexa. Am J Obstet Gynecol 97:974–977

    PubMed  CAS  Google Scholar 

  17. Eitan R, Galoyan N, Zuckerman B, Shaya M, Shen O, Beller U (2007) The risk of malignancy in post-menopausal women presenting with adnexal torsion. Gynecol Oncol 106:211–214

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank all the study participants and research staff of the Department of Obstetrics and Gynecology, Faculty of Medicine, Selcuk University. No funding for the study was received.

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Correspondence to Osman Balci.

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Balci, O., Icen, M.S., Mahmoud, A.S. et al. Management and outcomes of adnexal torsion: a 5-year experience. Arch Gynecol Obstet 284, 643–646 (2011). https://doi.org/10.1007/s00404-010-1702-z

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  • DOI: https://doi.org/10.1007/s00404-010-1702-z

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