ABSTRACT
Study Objective
Our objective was to determine if ovarian surgery at the time of ovarian detorsion
is associated with impaired short-term ovarian function as indicated by ovarian morphology
on ultrasound when compared with detorsion alone.
Design
Retrospective cohort study
Setting
The Hospital for Sick Children, Toronto
Participants
Patients ≤ 18 years old with confirmed ovarian torsion from January 1, 2004, to December
31, 2018, with ovarian-sparing surgery.
Main Outcome Measures
Data were collected on demographics, procedure, intraoperative findings, and postoperative
ultrasound. To determine ovarian function, we compared the morphology on the postoperative
ultrasound between those with surgery to the ovary and those without surgery to the
ovary at the time of detorsion. We also compared the ovarian volume of affected and
contralateral ovaries after detorsion and surgery to the affected ovary.
Results
One hundred and nineteen patients met the inclusion criteria, of whom 67 (56%) had
detorsion with surgery to the ovary and 52 (44%) had detorsion alone. There was no
statistically significant difference in appearance on the postoperative ultrasound
between these groups (P =.446). There was also no statistically significant difference on the postoperative
ultrasound of affected and contralateral ovarian volumes after detorsion and surgery
to the affected ovary (P = .69). Patients who underwent surgery to the ovary experienced a lower rate of recurrence;
however, this did not reach statistical significance, with a P value of 0.080.
Conclusion
Our study demonstrates that surgery, eg cystectomy to the ovary at the time of ovarian
detorsion, does not appear to impact ovarian function when compared with detorsion
alone, as indicated on postoperative imaging. There was also no difference in volume
of the affected and contralateral ovaries in those cases that underwent surgery at
the time of initial detorsion. This evidence would support that immediate cystectomy
at the time of initial ovarian detorsion is not associated with impaired ovarian function,
thus avoiding the need for an interval cystectomy.
Key Words
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References
- Ovarian torsion: a fifteen-year review.Ann Emerg Med. 2001; 38: 156-159
- Evolution in the management of pediatric and adolescent ovarian torsion as a result of quality improvement measures.J Pediatr Adolesc Gynecol. 2017; 30: 132-137
- Ovarian torsion in premenarchal girls.J Pediatr Adolesc Gynecol. 2019; 32: 254-258
- A review of ovary torsion.Ci Ji Yi Xue Za Zhi. 2017; 29: 143-147
- Adnexal salvage through a 2-stage laparoscopic operation in a young woman with adnexal torsion.Acta Med Nagasaki. 2021;; 56: 81-83
- Should the ovary always be conserved in torsion? A tertiary care institute experience.J Pediatr Surg. 2014; 49: 465-468
- Laparoscopy versus laparotomy for detorsion and sparing of twisted ischemic adnexa.JSLS. 2003; 7: 295-299
- Ovarian torsion in children: is oophorectomy necessary?.J Pediatr Surg. 2004; 39: 750-753
- Ovarian torsion. Management and ovarian prognosis: a report of 45 cases.J Pediatr Surg. 2009; 44: 1759-1765
- Pediatric ovarian torsion: follow- up after preservation of ovarian tissue.J Pediatr Surg. 2019; 54: 1453-1456
- No. 341-Diagnosis and management of adnexal torsion in children, adolescents, and adults.J Obstet Gynaecol Can. 2017; 39: 82-90
- Ovarian torsion in pediatric and adolescent patients: a systematic review.J Pediatr Surg. 2018; 53: 1387-1391
- Ovarian torsion in a 5-year old: a case report and review.Case Rep Emerg Med 2012. 2012; 679121
- ACOG Committee Opinion No. 783.Obstet Gynecol. 2019; 134: e56-e63
- Recovery of ovarian function after laparoscopic detorsion.Hum Reprod. 1995; 10: 2965-2966
- Predominant etiology of adnexal torsion and ovarian outcome after detorsion in premenarchal girls.Eur J Pediatr Surg. 2010; 20: 298-301
- Conservative laparoscopic approach to adnexal torsion.Arch Gynecol Obstet. 2008; 277: 535-538
- Laparoscopic detorsion and fertility preservation in twisted ischemic adnexa - a single-center prospective study.Gynecol Minim Invasive Ther. 2020; 9: 24-28
- Torsion of normal adnexa in postmenarchal women and risk of recurrence.Obstet Gynecol. 2007; 109: 355-359
Article info
Publication history
Published online: November 04, 2021
Accepted:
October 28,
2021
Received in revised form:
October 5,
2021
Received:
April 26,
2021
Identification
Copyright
© 2021 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
