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ORIGINAL ARTICLE
Year : 2019  |  Volume : 2  |  Issue : 4  |  Page : 273-280

Recent conservative management trends in dealing with uterine adnexal torsion will preserve fertility in childbearing women: a review of literature and case series


Department of Obstetrics and Gynaecology, Al-Galaa Maternity Teaching Hospital, Cairo, Egypt

Correspondence Address:
Hossam H Soliman
Aysha Al Taymoria Street, Garden City, Cairo 11541
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JMISR.JMISR_60_19

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Introduction Uterine adnexal torsion is a rare gynecologic emergency, representing 2.5–7% of all the acute gynecologic surgical conditions. It could lead to adnexal ischemia and necrosis, putting a woman at the risk of a radical surgery, which leads her to lose a uterine adnexa, plummeting her future fertility, and possibility inducing a negative effect of her future marital and family life. Adnexal detorsion associated with cystectomy is a simple maneuver that could spare the woman of losing her ovary; this technique could successfully work even with an apparently necrosed ovary. Aim A review of literature, in addition to a retrospective observational study was done, the aim of this study was to assess the potential of saving a torsed, devitalized adnexa, through the less radical detorsion technique and simple cystectomy. Results Several studies have favored ovarian detorsion, cystectomy, and ovariopexy, as combined techniques, if done altogether could spare an ovary being removed for being necrosed. The present retrospective study of 12 cases with ovarian torsion revealed complying findings, where two of five patients with suspected adnexal necrosis were treated conservatively by combined detorsion and cystectomy, with the ovaries resuming normal activity soon within a few weeks. Conclusion Many apparently necrosed ovaries could be spared unnecessary excision, through implying a more conservative techniques, such as ovarian detorsion and cystectomy, with no marked detrimental consequences.


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