CONSERVATIVE MANAGEMENT OF ADNEXAL TORSION

OBJECTIVES: Our purpose was to evaluate morbidity in patients who unde rwent conservative therapy, ovarian cystectomy, for adnexal torsion co mpared with those who underwent salpingo-oophorectomy and to determine predictive factors associated with the ability to perform conservativ e surgery. STUDY DESIGN: A retrospective review of all women < 40 year s old with adnexal torsion treated between May 1, 1989, and Dec. 31, 1 991, was performed. All potentially viable adnexa were untwisted, and cystectomies were performed unless the adnexa failed to reperfuse. RES ULTS: Ninety-four women were studied, and of these 61 (65%) received o varian cystectomies and 33 (35%) underwent salpingo-oophorectomy. No t hromboembolic complications or increase in postoperative morbidity was seen. Patients requiring salpingo-oophorectomy had more preoperative fevers and leukocytosis, larger masses, and higher degrees of torsion. CONCLUSION: Conservative surgery with untwisting of the adnexa follow ed by cystectomy can be performed in reproductive-age women with adnex al torsion who have potentially viable adnexa.