Tactics of the surgical treatment of torsion of the SINGLE uterine appendages in nulliparous women

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract


There are considered two clinical cases of torsion of the single uterine appendages in patients of reproductive age without pregnancies in a history. Both patients previously were undergone to adnexectomy due to adnexal torsion. After clinical and laboratory examination and intraoperative endoscopic visualization of the pelvic organs it was decided advisory to limit the amount of surgical intervention by means of unwinding the uterus by laparoscopic method. Taking into account the adnexal torsion on the opposite side (with subsequent adnexectomy) in a history the main stage of the surgical treatment was supplemented by ovariopexy to prevent disease recurrence. Postoperative control for the restoration of blood supply to the ovarian tissues includes programmed laparoscopic examination, monochrome ultrasound scanning, color Doppler mapping (CDM), the study of blood levels of sex hormones, a common clinical and biochemical analyzes of blood, coagulogram.

Full Text

Restricted Access

About the authors

Anatoly I. Ishchenko

I.M. Sechenov First Moscow State Medical University

Email: 7205502@mail.ru
Moscow, 119991, Russian Federation
MD, PhD, DSci, Professor, Head of the Department of Obstetrics and Gynecology of the I.M. Sechenov First Moscow State Medical University

A. A Ishchenko

I.M. Sechenov First Moscow State Medical University

Moscow, 119991, Russian Federation

A. A Bakhvalova

I.M. Sechenov First Moscow State Medical University

Moscow, 119991, Russian Federation

A. A Devitskiy

I.M. Sechenov First Moscow State Medical University

Moscow, 119991, Russian Federation

A. I Maksimov

I.M. Sechenov First Moscow State Medical University

Moscow, 119991, Russian Federation

References

  1. Anders J.F., Powell E.C. Urgency of evaluation and outcome of acute ovarian torsion in pediatric patients. Arch. Pediatr. Adolesc. Med. 2005; 159(6): 532-5.
  2. Argenta P.A., Yeagley T.J., Ott G., Sondheimer S.J. Torsion of the uterine adnexa. Pathologic correlations and current management trends. J. Reprod. Med. 2000; 45: 831-6.
  3. Bider D., Ben-Rafael Z., Goldenberg M. Pregnancy outcome after unwinding of twisted ischaemic-haemorrhagic adnexa. Br. J. Obstetr. Gynaecol. 1989; 96(4): 428-30.
  4. Breech L.L., Hillard P.J.A. Adnexal torsion in pediatric and adolescent girl. Curr. Opin. Obstetr. Gynecol. 2005; 17: 483-7.
  5. Canis M., Manhes H., Wattiez A., Mage G., Pouly J.L., Bruhat M.A. Long-term follow-up after conservative laparoscopic management of adnexal torsion. In: Abstracts of the 18th Annual Meeting of the ESHRE. Vienna; 2002.
  6. Ements M., Doornewaard H., Admiraal J.C. Adnexal torsion in very young girls: Diagnostic pitfalls. Eur. J. Obstetr. Reprod. Biol. 2004; 116: 207-10.
  7. Germain M., Rarick T., Robins E. Management of intermittent ovarian torsion by laparoscopic oophoropexy. Obstetr. And Gynecol. 1996; 88(4, Pt 2): 715-7.
  8. Hibbard L.T. Adnexal torsion. Am. J. Obstetr. Gynecol. 1985; 152(4): 456-61.
  9. Houry D., Abbott J.T. Ovarian torsion: a fifteen-year review. Ann. Emerg. Med. 2001; 38(2): 156-9.
  10. Lee E.J., Kwon H.C., Joo H.J. Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J. Ultrasound Med. 1998; 17(2): 83-9.
  11. Oelsner G., Shashar D. Adnexal torsion. Clin. Obstetr. Gynecol. 2006; 49(3): 459-63.
  12. Panayotidis C., Nisolle M. Recent advances of laparoscopic approach in adnexal torsion of premenarcheal girl. Gynecol. Surg. 2007; 4: 155-60.
  13. Peterson W.F., Prevost E.C., Edmunds F.T., Hundley J.M. Jr, Morris F.K. Benign cystic teratomas of the ovary; a clinico-statistical study of 1,007 cases with a review of the literature. Am. J. Obstetr. Gynecol. 1955; 70: 368-82.
  14. Sommerville M., Grimes D.A., Koonings P.P., Campbell K. Ovarian neoplasms and the risk of adnexal torsion. Am. J. Obstetr. Gynecol. 1991; 164(2): 577-8.
  15. Steyaert H., Meynol F., Valla J.S. Torsion of the adnexa in children: value of laparoscopy. Pediatr. Surg. Int. 1998; 13: 384-4.
  16. Warner M.A., Fleischer A.C., Edell S.L. et al. Uterine adnexal torsion: sonographic findings. Radiology. 1985; 154(3): 773-5.
  17. Yiu-Tai Li, Lung-Ching Kuon, Po-Ning Lee, Tsung-Cheng Kuo. Laparoscopic detorsion of twisted ovary. J. Chin. Med. Assoc. 2005; 68: 595-8.
  18. Хирш Х.A., Казер O., Икле Ф.A. Оперативная гинекология: Атлас. Пер. с англ. М.: ГЭОТАР-Медиа; 1999.
  19. Айламазян Э.К., Рябцева И.Т. Неотложная помощь при экстренных состояниях в гинекологии. М.: Медкнига; 2003.
  20. Поддубный И.В., Дьяконова Е.Ю., Глыбина Т.М., Исаев А.А., Короткова С.А. Повторная лапароскопия после деторсии нормальных придатков матки у девочек. Тезисы VIII Съезда Российского общества эндохирургов. М.; 2005: тез. 116.

Statistics

Views

Abstract - 29

PDF (Russian) - 0

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies