Гинекология и акушерство

Гинекология и акушерство
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ISSN: 2161-0932


Conservative Management of Ovarian Torsion

Kevin Ke*, Dean Helmar Conrad, Gregory Miles Cario

Ovarian torsion is a common gynaecological emergency, affecting women of all ages, with a peak incidence around the age of 30. Risk factors include enlarged ovaries secondary to ovarian cysts, ovarian hyperstimulation syndrome and ovulation induction, as well as tubal ligation and pregnancy. Diagnosis is primarily clinical, with laboratory and imaging investigations providing further support. Current management primarily consists of oophorectomy, although there is a trend towards preserving ovarian tissue through a combination of detorsion, ovarian cystectomy and oophoropexy. There is increasing evidence that necrotic appearing ovaries that do not appear to recover immediately following detorsion can still be viable in the long term. Furthermore, a policy of ovarian conservation for all pre-menopausal women with ovarian torsion appears to result in very good outcomes and low rates of complications, suggesting that oophorectomy should be reserved primarily for post-menopausal women.