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Conservative management of adnexal torsion
1Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
Objectives:
Our purpose was to evaluate morbidity in patients who underwent conservative therapy, ovarian cystectomy, for adnexal torsion compared with those who underwent salpingo-oophorectomy and to determine predictive factors associated with the ability to perform conservative surgery.
Study Design:
A retrospective review of all women < 40 years old with adnexal torsion treated between May 1, 1989, and Dec. 31, 1991, was performed. All potentially viable adnexa were untwisted, and cystectomies were performed unless the adnexa failed to reperfuse.
Results:
Ninety-four women were studied, and of these 61 (65%) received ovarian cystectomies and 33 (35%) underwent salpingo-oophorectomy. No thromboembolic complications or increase in postoperative morbidity was seen. Patients requiring salpingo-oophorectomy had more preoperative fevers and leukocytosis, larger masses, and higher degrees of torsion.
Conclusion:
Conservative surgery with untwisting of the adnexa followed by cystectomy can be performed in reproductive-age women with adnexal torsion who have potentially viable adnexa.