Pediatric ovarian torsion: Follow- up after preservation of ovarian tissue

Geimanaitė, Lina; Trainavičius, Kęstutis

doi:10.1016/j.jpedsurg.2019.02.004

Cited by 21 publications

(12 citation statements)

References 30 publications

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“…In our study benign tumors that cause an ovarian torsion accounted for 11 of 46 cases, 1 was mature ovarian teratoma, whereas hemorrhagic cysts were 10 and and torsions without any ovarian malformations were only 5 (0.1%). This is consistent with other studies demonstrating that ovarian torsion due to ovarian malignancy is extremely rare, with an estimated incidence of 0,5-8% (2), (3), (5).…”

Section: Discussionsupporting

confidence: 93%

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Fertility preservation in ovary pathologies in pediatric patients

Tzortzopoulou

Vracka

Chra

et al. 2021

DAH

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Purpose: To study cases with ovarian torsion or ovarian tumors and hemorrhagic cysts and to review those who underwent ovary sparing surgery in a follow up period of 1 month, 3 months and 1 year. Methods: A prospective study of 46 youth and adolescent patients, from 6 to 16 years old, were prospectively studied from October 2015 to October 2020, in a single tertiary care children's hospital. All underwent radical or ovary- sparing operative management, due to ovarian torsion or ovarian tumor/cyst. Statistical analysis was performed with SPSS (ve 24 SPSS Inc., Chicago, IL,USA). Results: Sixteen patients underwent radical surgery, while ovary sparing surgery was performed in thirty three. Overall, 5 were diagnosed with ovarian torsion, 11 with ovarian or fallopian tube torsion due to hemorrhagic cyst or tumor and 30 with ovarian tumor (23 benign and 7 malignant). Benign or malignant etiology was confirmed through biopsy. Ultrasound was used for diagnosis in all patients, while CT scan or MRI only in 18 cases, especially in those with strong indications of tumor pathology. Initial operation was performed laparoscopically in 30% of patients, without any conversion to open surgery. In all patients postoperative ovarian ultrasound imaging was performed 1 and 3 months after surgery. An ultrasound follow-up 12 months postoperatively was performed in 38 patients. Conclusion: Ovarian-sparing operations are safe for ovarian torsion and benign ovarian tumors and conferred successful clinical outcomes of low recurrence and repeated surgery rates. It is also a viable approach in children and young girls in an attempt to preserve future fertility.

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Section: Discussionsupporting

confidence: 93%

“…In our patients, an ultrasonography was performed 1 and 3 months after the ovary sparing surgery. A complete functional preservation of ovarian tissue has been proved (2), (5).…”

Section: Discussionmentioning

confidence: 99%

Fertility preservation in ovary pathologies in pediatric patients

Tzortzopoulou

Vracka

Chra

et al. 2021

DAH

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“…We have started to be more active in performing ovary-sparing procedures nowadays since good long term results have been observed with ovary-sparing surgery in pediatric patients despite black-bluish color in twisted ovary. 15,22 On the other hand, our results showed a greater rate of ovary-sparing procedures in infants compared to a previous study reporting only 14%…”

Section: Accepted Articlecontrasting

confidence: 73%

Surgically treated ovarian lesions in preadolescent girls

Ripatti

Taskinen

Koivusalo

et al. 2019

Acta Obstet Gynecol Scand

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Introduction: The purpose of this study was to investigate the epidemiology and characteristics of surgically treated ovarian lesions in preadolescent girls. Material and Methods: This was a retrospective cohort study including all 0-11-year-old girls operated at a single center from 1999 to 2016 for ovarian cysts, neoplasms, or torsions. Patient charts were reviewed for symptoms, preoperative radiological imaging, operative details, and histopathology. Results: We identified 78 girls resulting in a population-based incidence of 4.2/100 000. Infants (n= 44) presented with benign cysts (42/44, 95%, one bilateral), a benign neoplasm (1/44, 2%), and a torsion without other pathology (1/44, 2%). Torsion was found in 25/29 (86%) ovaries with complex and in 3/15 (21%) ovaries with simple cysts in preoperative imaging (p<0.001). Most infants were asymptomatic. Lesions in 1-11-year-old girls (n=34) included benign neoplasms (n=21/34, 62%), malignant neoplasms (n=5/34, 15%), a cyst with torsion (n=1/34, 3%), and torsions without other pathology (n=7/34, 21%). Torsion was more common in benign (17/21, 81%) than in malignant neoplasms (1/5, 20%) (p<0.020). Ovarian diameter did not differ between ovaries with or without torsion (p=0.238), or between benign and malignant neoplasms (p=0.293). The duration of symptoms in lesions with or without torsion was similar. Conclusions: The majority of surgically treated ovarian lesions in preadolescent are benign lesions with torsion. Surgery should be ovary preserving and performed without delay.

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“…Ovarian cyst or tumor is associated with it. Ovarian torsion is more prevalent on the right side because the left side of the ovary is less likely to rotate due to the presence of the sigmoid colon (1,19,20). The results of the present study showed that ovarian TD causes tissue, hormonal, and biochemical damage, and an appropriate dose of the orange peel extract due to its antiinflammatory and antioxidant properties can improve these effects.…”

Section: Discussionmentioning

confidence: 55%

Protective Effect of Hydroalcoholic Extract of Orange Peel on PCNA and FSH-R Gene Expression in Histological Damage and Oxidative Stress Due to Ovarian Torsion in Adult Rats

Nejad

Khaki

Abbasalizadeh

et al. 2021

International Journal of Women’s Health and Reproduction Scienc

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Objectives: The aim of this study was to evaluate the protective effect of the hydroalcoholic extract of orange peel on proliferating cell nuclear antigen (PCNA) and follicle-stimulating hormone receptor (FSH-R) gene expression in histological injuries and acid stress caused by ovarian torsion in adult rats. Materials and Methods: In this experimental study, 32 adult female rats were randomly divided into 4 groups. In group 1 (Sham), the abdominal wall was cut without applying torsion and in group 2, ovarian torsion was performed for 2 hours, followed by detorsion for 2 weeks. The hydro-alcoholic extract of orange peel was added to their diet for two weeks in group 3, followed by ovarian torsion for 2 hours and detorsion for 2 hours. Group 4 received the orange peel extract for two weeks and after then ovarian resection for the evaluation of histological damage and blood sampling to examine the serum level of antioxidant enzymes, as well as the expression of PCNA and FSH-R genes in the ovarian tissue. Results: Histological changes in the ovary tissue of rats showed that torsion and detorsion have destructive effects on the ovarian tissue, and torsion/detorsion led to a reduction in the expression of PCNA and FSH-R (P < 0.05). Based on biochemical and hormonal results, the ovarian torsion resulted in an imbalance in the oxidative stress markers and hormone profile of rats. Finally, the administration of the hydroalcoholic extract of orange peel due to its high antioxidant properties improves these effects. Conclusions: In general, administering an appropriate dose of the hydroalcoholic extract of orange peel for two consecutive weeks in the diet had a protective effect on the ovarian tissue at the risk of torsion/detorsion.

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Pediatric ovarian torsion: Follow- up after preservation of ovarian tissue

Cited by 21 publications

References 30 publications

Fertility preservation in ovary pathologies in pediatric patients

Fertility preservation in ovary pathologies in pediatric patients

Surgically treated ovarian lesions in preadolescent girls

Protective Effect of Hydroalcoholic Extract of Orange Peel on PCNA and FSH-R Gene Expression in Histological Damage and Oxidative Stress Due to Ovarian Torsion in Adult Rats

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