Adnexal torsion: a review of diagnosis and management strategies

Chang-Patel, Erica J.; Palacios-Helgeson, Leslie K.; Gould, Claire

doi:10.1097/gco.0000000000000787

Cited by 10 publications

(5 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has become clear that the appearance of the ovary during surgery does not correlate well with subsequent ovarian recovery and function ( 10 , 11 , 19 ). According to current guidelines, oophorectomy is unnecessary in cases of black discoloration of the ovary seen during surgery ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Influence of ovarian torsion on reproductive outcomes and mode of delivery

Silberstein,

Freud,

Baumfeld

et al. 2024

Front. Med.

View full text Add to dashboard Cite

PurposeTo investigate differences in reproductive outcomes among patients before and following ovarian torsion.Study designIn this retrospective cohort study, we investigated the reproductive outcomes of patients who underwent surgery for ovarian torsion between 1988 and 2015 in a tertiary medical center. Data on deliveries before and after ovarian torsion were compared.ResultsDuring the study period, 199 women underwent surgery due to ovarian torsion. The majority (91.4%; n = 182) underwent detorsion, and 8.6% (n = 17) underwent unilateral adnexectomy. At the time of the torsion, 27.6% (n = 55) of patients were pregnant. Among women who suffered from ovarian torsion, about half (52%) of the deliveries occurred before the torsion and 48% following the torsion. No significant difference in the live birth rate was noted (p = 0.19). The fertility treatment rate in our cohort was 7.5% before and 5% after the torsion (p = 0.01). In addition, live birth, cesarean delivery, and fertility treatment rates were similar in women who underwent detorsion vs. those who had adnexectomy.ConclusionSurgically treated ovarian torsion does not appear to negatively influence fertility and live birth potential.

show abstract

Section: Discussionmentioning

confidence: 99%

“…This surgical approach was found to cause subfertility or early-onset menopause (9). In recent years, there has been a shift to a fertility sparing treatment, following studies that demonstrated viability of the ovary after detorsion (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Influence of ovarian torsion on reproductive outcomes and mode of delivery

Silberstein,

Freud,

Baumfeld

et al. 2024

Front. Med.

View full text Add to dashboard Cite

show abstract

“…In all studies examining follicular development in the preservation of the ovary after detorsion in humans, it has been shown that the function of the ovary continues. 4 However, the follicle cohort may be adversely affected despite the ovary remaining viable after detorsion. The increase in ovarian tissue damage has been attributed to oxidative stress products of post-ischemia reperfusion.…”

Section: Discussionmentioning

confidence: 99%

“…Ovarian tissue should be preserved as much as possible, since in most studies, normal follicle development is seen after detorsion of even an ovary that appears to be bluish-black in color during surgery. 4 In patients with torsion who have completed their fertility, are older, or have a suspected malignant mass, the surgeon can decide on an oophorectomy more easily. However, there are reservations about performing cystectomy during detorsion in young women and on masses that are presumed to be benign.…”

mentioning

confidence: 99%

Effect of Simultaneous Cystectomy on Ovarian Reserve in Cases of Adnexal Torsion: A Prospective Case-Control Study

KURTOĞLU AKSOY,

KOVALAK,

ŞAN KARAMAN

2023

J Clin Obstet Gynecol

View full text Add to dashboard Cite

Adnexal torsion is one of the gynecological surgical emergencies that can be seen in women of all ages, with or without an ovarian cyst. In this study, it was aimed to investigate the effect of performing cystectomy on ovarian reserve in an ovary exposed to ischemia during emergency surgery in cases of adnexal torsion with an ovarian cyst, which is presumed to be benign. Material and Methods: The ovaries of nineteen women who underwent laparoscopic detorsion due to adnexal torsion (Group 1) and the ovaries of ten women who underwent laparoscopic detorsion+cystectomy in the same session with adnexal torsion due to a cyst, which was presumed to be benign (Group 2) were compared in terms of ovarian volume and antral follicular counts (AFC). Results: There was no statistically significant difference between the volumes and AFCs of the operated ovaries of the women in Group 1 (ovarian volume 11.56±9.58 cm3, AFC: 8.52±5.92 cm3) and the women in Group 2 (ovarian volume 10.99±5.07 cm3, AFC: 9.20±3.15 cm3) (p>0.05). Conclusion: Performing a cystectomy during detorsion surgery for a cyst presumed to be benign in a torsioned ovary exposed to ischemia does not seem to do any additional harm when evaluated in terms of AFC and volume.

show abstract

“…Swelling and blood flow obstruction result from this. Initial obstruction of the venous outflow is followed by interruption of the arterial inflow as a result of increased swelling, which results in ovarian necrosis, infarction, hemorrhage, and possibly peritonitis [ 19 ]. Because the sigmoid colon is located in the left pelvis, the right side has been seen more frequently than the left; this is thought to be a result of the increased space in the right pelvis [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Ovarian Torsion in Polycystic Ovary Syndrome: A Potential Threat?

Psilopatis,

Damaskos,

Garmpis

et al. 2023

Biomedicines

View full text Add to dashboard Cite

Polycystic ovary syndrome (PCOS) constitutes the most prevalent endocrine disorder in women of reproductive age worldwide. Given the increased risk of ovarian torsion in the presence of large ovarian cysts, polycystic ovarian syndrome could be regarded as one of the most significant risk factors for ovarian and/or adnexal torsion in cases of significantly enlarged ovaries. The aim of the present review is to investigate, for the first time, the association between polycystic ovarian syndrome and ovarian torsion. We performed a review of the literature using the MEDLINE and LIVIVO databases in order to find relevant studies. By using the search terms “polycystic ovarian syndrome” and “ovarian torsion”, we were able to identify 14 studies published between 1995 and 2019. The present work constitutes the most up-to-date, comprehensive literature review focusing on the risk of ovarian/adnexal torsion in patients with polycystic ovaries. Ovarian/adnexal torsion seems to be a feared complication in patients with polycystic ovary syndrome. Acute lower abdominal pain in patients with known polycystic ovaries represents the most common symptom, while diagnostic assessment almost always incorporates transvaginal ultrasound and computer tomography or magnetic resonance tomography scans. In case of suspected torsion, emergency laparoscopy with ovarian or adnexal detorsion seems to be the standard therapeutic approach with a view to restitute the interrupted blood supply. In cases of repeated ovarian/adnexal torsions, ovariopexy or ovariectomy/adnexectomy had to be discussed with the patient in the context of risk recurrence minimization.

show abstract

Adnexal torsion: a review of diagnosis and management strategies

Cited by 10 publications

References 60 publications

Influence of ovarian torsion on reproductive outcomes and mode of delivery

Influence of ovarian torsion on reproductive outcomes and mode of delivery

Effect of Simultaneous Cystectomy on Ovarian Reserve in Cases of Adnexal Torsion: A Prospective Case-Control Study

Ovarian Torsion in Polycystic Ovary Syndrome: A Potential Threat?

Contact Info

Product

Resources

About