Obstet Gynecol Sci.  2023 Nov;66(6):562-571. 10.5468/ogs.23071.

Postoperative outcomes of ovarian preserving surgery in premenopausal women with adnexal torsion

• Choi E
• Kim HI
• Seo SK
• Cho SH
• Choi YS
• Lee BS
• Yun BH

• KMID: 2547857
• DOI: http://doi.org/10.5468/ogs.23071

Abstract

Objective
We aimed to determine whether ovarian-preserving surgery for adnexal torsion helps preserve ovarian function without increasing the risk of postoperative complications.
Methods
We retrospectively evaluated 71 women who were surgically diagnosed with adnexal torsion between January 2015 and December 2019 at Severance Hospital, Yonsei University College of Medicine (ovarian preservation group, 56; oophorectomy, 15). Serum anti-Müllerian hormone (AMH) levels measured within 6 months before surgery were compared to levels measured 6-24 months after surgery. Surgical findings and postoperative complications were compared between the groups.
Results
There was a borderline significant difference in the decrease in serum AMH levels between the oophorectomy group and ovarian preservation group before and after surgery. There were no significant differences between the groups in terms of fever, infection, or duration of admission. Discoloration of the twisted ovary was found in 27.3% and 33.3% of the patients in the ovarian preservation and oophorectomy groups, respectively. There was no difference in the decrease in serum AMH levels between patients with and those without discoloration.
Conclusion
Ovarian-preserving surgery may not increase postoperative complications in patients with adnexal torsion, even if a twisted mass is suspected to be necrotic. Moreover, the ovarian reserve may not be affected by torsion if the ovary is preserved. Conservative ovarian surgery can be safely performed to preserve the reproductive potential of women with adnexal torsion and cystic masses.

Keyword

Ovarian reserve; Postoperative complication; Ovarian torsion; anti-mullerian hormone

Figure

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  Fig. 1 Partial correlation between serum AMH change and variables (A) size of the rotaed ovary, (B) time interval between symptoms and surgery, as determined by correcting for each variable. Control variables: age, BMI, preop AMH, size of the twisted ovary, the interval between symptoms to surgery. AMH, anti-Müllerian hormone; BMI, body mass index; preop, preoperative.

Reference

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