Clinical Analyses Of Conservative Surgery In56Women With Adnexal Torsion

ObjectiveThe aim of this study was to evaluate ovarian function after conservative surgery in56cases with adnexal torsion.Materials and Methods56patients with surgically proven adnexal torsion at the Women’s Hospital, Zhejiang University, from2000January to2014August, were retrospetctively analysed. Clinical informations were obtained from the patients’medical records including onset of symptoms, preoperative ultrasound results (ovarian size, ovarian blood supply), state of torsion, degree of torsion, the color of adnexa, pathological examination. All patients were treated with conservative surgery for adnexal torsion. Ultrasound examination was done during1year follow-up period after operation. Ovarian function was assessed by ovarian blood supply, ovarian size and follicular development via ultrasound examination with color Doppler. According to different states of adnexal torsion, onset of symptoms (<72hours and≥72hours), preoperative ovarian blood supply (with and without), state of torsion (not complete torsion and completely torsion), degree of torsion (<1080degrees and≥1080degrees) and color of adnexa (bluish-black and red, or dark red), we analyzed the data and obtained the information on ovarian function at the interval of1month,3months,1year after surgery.ResultsAll56operations were successfully performed with less hemorrhage and these patients were well recovered postoperatively. No major complications occurred in the present study.11patients were lost to follow up. During follow-up ultrasonography with color Doppler was done for45ovaries, which showed normal volume ovaries with good vascularity and follicular development in42ovaries (93.3%) except three (6.7%). The following results were obtained:12of15(80%) patients with bluish-black appearance in ovaries had results of preservation of ovarian function, poorer than those patients with red, or dark red ovaries (100%). Except this parameter, others had no effect on ovarian function and the results were showed as follow:7of8(87.5%) patients with onset of symptoms over72hours had good results of preservation of ovarian function;6of7(85.7%) patients with no vascularity of preoperative ultrasound had results of preservation of ovarian function;31of33(93.9%) patients with complete adnexal torsion had results of preservation of ovarian function;5of5(100%) patients with over1080degrees had results of preservation of ovarian function.ConclusionConservative surgery is an available and safe option for adnexal torsion. In spite of bluish-black appearance in ovaries with poorer outcome, most of their function may recover in long-term follow-up. Some features, including onset of symptoms over72hours, no vascularity of preoperative ultrasound, complete adnexal torsion and over1080degrees, had no effect on the outcome of ovarian function. So, the conservative therapy should be recommended to treat with adnexal torsion, especially for young patients.