Laparoscopic detorsion of twisted ovarian adnexa and fertility preservation– A prospective Study

Abstract

Background: Presentre search was aimed to analyze our experience about the preservation of ovary in cases of adnexal torsion by laparoscopy, irrespective of the extent of necrosis and number of twists, and to assess the subsequent ovarian viability.  Methods: This was  a prospective study conducted at a tertiary care government medical college and cancer hospital. All the cohorts of intraoperative diagnosis of adnexal torsion were included irrespective of the age group from January 2018 to January 2020, after due permission from institutional ethics committee. Demographic details and clinical and operative findings were  recorded from willing participants. All patients underwent laparoscopy, except those withsuspected malignancy. Postoperatively, ovarian viability was assessed by ultrasound doppler in terms of vascularity and follicular development at the end of 1, 6, and 12 months. Results: A total of 24 patients completed this research. Acute abdominal pain 17 (70.83%) was the main presenting symptom in all age groups. The total number of cases of adnexal torsion was 23. Adnexal torsion was mainly diagnosed in young and adolescent girls. Out of 24 attempted detorsion, 23 ovaries were preserved (97.8%). Most of the pathologies were benign. All the preserved ovaries were showing follicles and vascularity during ultrasound follow-up. Conclusion: Laparoscopic detorsion of the ovary is the best treatment modality irrespective of the grade of ischemia. Ovarian structure and follicles were preserved following detorsion in all the cases, even in highly ischemic ovaries.