A national population-based study of the incidence of adnexal torsion in the Republic of Korea

Yuk, Jin‐Sung; Kim, Log Young; Shin, Ji‐Yeon; Choi, Do Young; Kim, Tae Yoon; Lee, Jung Hun

doi:10.1016/j.ijgo.2014.11.027

Cited by 33 publications

(27 citation statements)

References 4 publications

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“…Antioxidant compounds can be effective in preventing the overproduction of ROS and also can be used to overcome infertility disorders related to the OS (12,13). Many scientific studies showed that ovarian torsion/detorsion or ischemia-reperfusion could be the result of overproduction of ROS followed by the damages caused by OS (4,6,11). Production of OS by ovarian torsion/ detorsion may lead to damage to tissues and hormones such as decreasing the level of estrogen and the serum level of SOD and GPx, reducing the number of follicles, and also increasing the serum level of MDA and testosterone (12,13).…”

Section: Discussionmentioning

confidence: 99%

The Protective Effect of Matricaria chamomilla Extract on Histological Damage and Oxidative Stress Induced by Torsion/Detorsion in Adult Rat Ovary

Soltani¹,

Moghimian²,

Abtahi³

et al. 2017

International Journal of Women’s Health and Reproduction Scienc

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Introduction Ovarian torsion is one of the prevalent gynecologic emergencies, in which the adnexal components swing around their axis that leads to obstruction of arterial, venous, and/or lymphatic vessels (1). In this situation, gangrene and necrosis with the expansion of arterial insufficiency is followed by primary congestion and hemorrhagic infarction owing to venous and lymphatic obstruction. However, there is no data about the least number of turns to form the torsion and also there is no data for the duration of torsion that is necessary for the setting in of necrosis (2). Diagnosis of torsion is based on clinical indication and found by sonographic findings. Meanwhile a definite diagnosis is made only during surgery (1) Oophorectomy of the necrotic and/ or doubtful ovaries after torsion or incarceration is the preferred surgical treatment in contemporaneous practice. However, before maturity, the importance of losing the gonads is higher than its loss in later periods. Also, nonsynchronous contralateral torsion has an occurrence ranging between 2%-5%, therefore, is considered as a clinical catastrophe. Twenty-five percent of children with torsion have abnormal ovaries. Moreover, protection of the gonads is the main attention in children. Therefore, a more conservative approach has been recommended in the last research (2). In the past, remedial action to overcome ovarian torsion was surgical removal of the ovaries. Nowadays, due to the importance of the ovaries in fertility and secretion of sexual hormones, ovaries are retained (3). Ovarian torsion/detorsion or ischemia/reperfusion of ovary is a pathophysiologic event in which histological damage is associated with perfusion reduction followed by lack of oxygen (ischemia) in ovarian tissue. The inflammatory response induced by torsion/detorsion (reperfusion) can lead to vascular endothelial cells damage and microcirculation disorders that are largely responsible for the injury to the ovarian tissue. The damage caused by ischemia/reperfusion produces excessive reactive oxygen species (ROS) such as hydroxyl free radical species, hydrogen peroxide (H 2 O 2), and superoxide radical (4-6). Therefore, oxidation has wrecking effects on ovarian tissue, thus, antioxidant substances not only have great roles in the recovery process but also reverse the adverse effects. Natural products such as plant extracts are a good alternative for drugs used in oxidative damage (7).

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Section: Discussionmentioning

confidence: 99%

The Protective Effect of Matricaria chamomilla Extract on Histological Damage and Oxidative Stress Induced by Torsion/Detorsion in Adult Rat Ovary

Soltani¹,

Moghimian²,

Abtahi³

et al. 2017

International Journal of Women’s Health and Reproduction Scienc

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“…[1] The incidence of AT among women of reproductive age was 9.9 per 100,000 women. [2] AT occurs when the ovary and the fallopian tube twist, resulting in the strangulation of the blood supply. After several hours of AT, the ovary can become necrotic.…”

Section: Introductionmentioning

confidence: 99%

Association between pregnancy and adnexal torsion

et al. 2016

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The purpose of this study was to determine the effect of pregnancy on adnexal torsion (AT). We conducted a matched case-control study using the Korean Health Insurance Review and Assessment Service–National Inpatients Sample (HIRA-NIS) from 2009 to 2011. AT patients were defined as women with both a diagnostic code (N835) and a surgical code for AT. The AT patients were randomly matched 1:4 with women without AT by age and year of claim. In total, 545 AT cases and 2180 controls were enrolled from a total of 1,843,451 women. After adjustment for such covariates as age, pregnancy was found to be associated with a lower rate of AT (adjusted odds ratio 0.314, 95% confidence interval [CI] 0.237–0.416, P value <0.01) and ovarian hyperstimulation syndrome was associated with a higher rate of AT (adjusted odds ratio 20.091, 95% CI 3.607–111.908, P value <0.01). We found that pregnancy is a negative risk factor for AT. However, a further study is needed to elucidate the mechanisms underlying these results.

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“…Benign ovarian cysts, which are more common in reproductive years, were an attempted explanation of this condition (1). In previous reports, ovarian cysts were detected in more than 90% of patients who presented with AT, and the average size of the cysts on USG varied between 6 and 8 cm (11)(12)(13)(14)(15). In our case series, both the mean age of patients (30.6 years) and cyst size (7.4 cm) were consistent with previous reports; however, the percentage of detected ovarian cysts (74.2%) was slightly lower than others.…”

Section: Discussionmentioning

confidence: 93%

“…AT can occur in women of any age, although it generally occurs during the early reproductive years. In a report from Korea, the incidence of AT among women of all ages was 5.9 per 100.000 women, and the average age of occurrence of AT was 33.79 years (13). Benign ovarian cysts, which are more common in reproductive years, were an attempted explanation of this condition (1).…”

Section: Discussionmentioning

confidence: 99%

Adnexal Torsion: Difficulty in Diagnosis and Management

Taş¹,

Yavuz²

2018

Haseki

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To investigate both the diagnostic value of Dopplerultrasonography and factors influencing surgical intervention in patients with adnexal torsion (AT). Methods: We retrospectively examined medical records of 66 women with AT in a single center between January 2007 and December 2016. Results: Forty-three out of 66 patients (65.1%) with AT were correctly diagnosed preoperatively. On Doppler examination, reduced ovarian arterial blood velocity was observed in 39 patients (59.1%); and the sensitivity was 0.67. AT was diagnosed in 49 patients (74.2%) via laparotomy, and the number of patients who were subjected to radical treatment was higher than that of patients managed with conservative treatment (54.6% vs 45.4%). Although there was no difference in the surgical approaches (laparoscopy vs laparotomy) between the groups, age, gravidity, parity, body mass index, and ovarian cyst size were significantly lower in patients who were treated conservatively (p<0.05). Conclusion: The diagnostic value of Doppler examination for AT is limited and the decision for surgical management should not be delayed based on Doppler results. Early age, low gravidity, parity and body mass index, and small size of ovarian cyst on ultrasonography were indication for conservative treatment, whereas black-bluish macroscopic appearance had no influence on the preference towards the selection of treatment.

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A national population-based study of the incidence of adnexal torsion in the Republic of Korea

Cited by 33 publications

References 4 publications

The Protective Effect of Matricaria chamomilla Extract on Histological Damage and Oxidative Stress Induced by Torsion/Detorsion in Adult Rat Ovary

The Protective Effect of Matricaria chamomilla Extract on Histological Damage and Oxidative Stress Induced by Torsion/Detorsion in Adult Rat Ovary

Association between pregnancy and adnexal torsion

Adnexal Torsion: Difficulty in Diagnosis and Management

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