Lina Geimanaite1, Kestutis Trainavicius2. 1. Vilnius University, Faculty of Medicine, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius, Lithuania; Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Department of Pediatric Surgery, Vilnius, Lithuania. Electronic address: lgeimanaite@gmail.com. 2. Vilnius University, Faculty of Medicine, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius, Lithuania; Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Department of Pediatric Surgery, Vilnius, Lithuania.
Abstract
BACKGROUND: The aim of this study was to evaluate the efficiency of the preservation of ovarian tissue in cases of ovarian torsion. MATERIALS AND METHODS: A retrospective study was performed of patients treated at our hospital for ovarian torsion from January 2007 to December 2017. This research does not include patients with antenatal ovarian torsion and 1 girl with an immature teratoma, in whom the twisted ovary was removed during the initial operation. Follow-up ultrasonography of all patients was performed after 4-6 weeks and again after more than 12 weeks. Volume, blood flow and folliculogenesis of the ovary were measured and assessed. RESULTS: All 42 ovaries (39 patients) preserved their normal anatomy and folliculogenesis after detorsion. All patients had an enlarged ovary at the time of detorsion. In all cases of ovarian torsion, enlargement of the ovary up to an average of 58.14 ± 52.86 (17.37-86.83) ml was detected. After 4-6 weeks, all untwisted ovaries decreased in volume by an average of 9.01 ± 13.69 (2.33-9.30) times, and 59.5% of them became normal in size. In 3 girls, enlarged ovaries were still observed after 12 weeks. Teratoma was diagnosed for these patients and ovarian sparing operations were performed. CONCLUSIONS: It is safe to perform detorsion regardless of the level of ischemia or volume of the affected ovary. The follow-up is essential, especially for the further diagnostics of potential pathological structures or tumors; therefore, the normalization of blood flow and the volume of the ovary must be monitored. TYPE OF STUDY: Prognosis retrospective study. LEVEL OF EVIDENCE: II.
BACKGROUND: The aim of this study was to evaluate the efficiency of the preservation of ovarian tissue in cases of ovarian torsion. MATERIALS AND METHODS: A retrospective study was performed of patients treated at our hospital for ovarian torsion from January 2007 to December 2017. This research does not include patients with antenatal ovarian torsion and 1 girl with an immature teratoma, in whom the twisted ovary was removed during the initial operation. Follow-up ultrasonography of all patients was performed after 4-6 weeks and again after more than 12 weeks. Volume, blood flow and folliculogenesis of the ovary were measured and assessed. RESULTS: All 42 ovaries (39 patients) preserved their normal anatomy and folliculogenesis after detorsion. All patients had an enlarged ovary at the time of detorsion. In all cases of ovarian torsion, enlargement of the ovary up to an average of 58.14 ± 52.86 (17.37-86.83) ml was detected. After 4-6 weeks, all untwisted ovaries decreased in volume by an average of 9.01 ± 13.69 (2.33-9.30) times, and 59.5% of them became normal in size. In 3 girls, enlarged ovaries were still observed after 12 weeks. Teratoma was diagnosed for these patients and ovarian sparing operations were performed. CONCLUSIONS: It is safe to perform detorsion regardless of the level of ischemia or volume of the affected ovary. The follow-up is essential, especially for the further diagnostics of potential pathological structures or tumors; therefore, the normalization of blood flow and the volume of the ovary must be monitored. TYPE OF STUDY: Prognosis retrospective study. LEVEL OF EVIDENCE: II.
Authors: Alexandra Tielli; Andrea Scala; Marianne Alison; Van Dai Vo Chieu; Nicholas Farkas; Luigi Titomanlio; Léa Lenglart Journal: Eur J Pediatr Date: 2022-01-30 Impact factor: 3.183