Gonadal TorsionOvarian torsion in pediatric and adolescent patients: A systematic review
Section snippets
Research questions
The American Pediatric Surgical Association (APSA) Outcomes and Evidence Based Practice (OEBP) committee vetted and selected the following questions for this systematic review:
- 1.
What are the risks of ovarian detorsion?
- a.
What is the risk of pulmonary embolism?
- b.
What is the risk of leaving malignancy behind?
- a.
- 2.
Is oophoropexy indicated at the time of detorsion?
- 3.
What are the benefits of ovarian detorsion?
- a.
Does recovery of ovarian function correlate with gross appearance at the time of operation?
- b.
Is there
- a.
Results
- 1)
What are the risks of ovarian detorsion?
- a.
What is the risk of pulmonary embolism?
- a.
The risk of pulmonary embolism is often quoted as the primary indication for performing an oophorectomy rather than detorsion. The putative mechanism of thromboembolism is the potential release of thrombi from the vascular pedicle subsequent to ovarian detorsion. McGovern examined the literature and noted two definitive cases of pulmonary embolism (PE) associated with ovarian torsion since 1900; both of those cases
Conclusion
Management of ovarian torsion in children and adolescents is variable and differs among surgical specialists. Additionally, studies have shown regional disparity in the management of the pediatric patient with ovarian torsion. Despite evidence demonstrating the safety of detorsion of ovaries, oophorectomy remains the operation most commonly performed by pediatric surgeons. Based on this review it is clear that ovarian detorsion and preservation should be the procedure of choice in pediatric
References (39)
Ovarian torsion
Semin Pediatr Surg
(2005)Ovarian cystectomy of twisted cysts
Lancet
(1946)- et al.
Emergency management and conservative surgery of ovarian torsion in children: a report of 40 cases
J Pediatr Adolesc Gynecol
(2008) - et al.
Ovarian torsion in children: is oophorectomy necessary?
J Pediatr Surg
(2004) - et al.
Current trends in the surgical treatment of pediatric ovarian torsion: we can do better
J Pediatr Surg
(2015) - et al.
Adnexal torsion: review of the literature
J Minim Invasive Gynecol
(2014) - et al.
Surgical management of benign adnexal masses in the pediatric/adolescent population: an 11-year review
J Pediatr Adolesc Gynecol
(2017) - et al.
Presentation, diagnosis, and treatment of ovarian torsion in premenarchal girls
J Pediatr Adolesc Gynecol
(2015) - et al.
Asynchronous bilateral ovarian torsion
J Pediatr Surg
(2004) - et al.
Ovarian torsion in children: management and outcomes
J Pediatr Surg
(2013)
Pediatric ovarian malignancy presenting as ovarian torsion: incidence and relevance
J Pediatr Surg
Surgical approach to ovarian torsion in children
J Pediatr Adolesc Gynecol
Management of intermittent ovarian torsion by laparoscopic oophoropexy
Obstet Gynecol
Torsion of the normal uterine adnexa in premenarchal girls
J Pediatr Surg
Maximizing ovarian salvage when treating idiopathic adnexal torsion
J Pediatr Surg
Rates and technique for oophoropexy in pediatric ovarian torsion: a single institution case series
J Pediatr Adolesc Gynecol
Ovarian torsion: to pex or not to pex? Case report and review of the literature
J Pediatr Adolesc Gynecol
Long-term results of conservative management of adnexal torsion in children
J Pediatr Surg
Adnexal torsion in children may have a catastrophic sequel: asynchronous bilateral torsion
J Pediatr Surg
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