Outcome Following Detorsion of Torsed Adnexa in Children

Abstract Study Objective To examine the postoperative course and outcomes of young females with ovarian torsion treated with detorsion and ovarian preservation. The secondary objective was to determine which operative findings correlated with higher follicular counts following detorsion. Design Retrospective chart review. Setting Tertiary academic center. Participants 29 females (mean age 10.3 ± 4.9 y) who underwent surgery for ovarian torsion with detorsion and ovarian preservation at our institution between July 2007 and July 2010 and who had follow-up pelvic ultrasonography available for review. Interventions None. Main Outcome Measures Surgical findings, postoperative complications, and follicular counts on follow-up ultrasonography. Results Mean duration of abdominal pain on presentation was 77.5 ± 78.8 h. The detorsed ovary was described as “dusky/purple” in 21 cases (72.4%), “normal” in 1 (3.4%), “necrotic” in 1 (3.4%), and not described in 6 (20.7%). All pubertal patients resumed menstrual function. No patients required reoperation for removal of the salvaged ovary. There were no instances of postoperative fever or concern for ovarian venous thrombosis. Average timing of follow-up ultrasonography was 8.1 ± 6.7 months, with 28 patients (96.6%) showing ovarian follicles on the affected side (mean 4.6 ± 1.9 and 4.7 ± 3.3 follicles on the right and left ovary, respectively). No correlation was found between the side affected, gross appearance of the torsed ovary or the number of follicles found on follow-up ultrasonography. Conclusions Detorsion with ovarian preservation is a safe and effective treatment, and should be considered the primary treatment for girls with ovarian torsion, even for those with ovaries that appear necrotic.