Torsion of the previously normal uterine adnexa - Evaluation of the correlation between the pathological changes and the clinical characteristics

Background Treatment of adnexal torsion remains a clinical dilemma when fut ure fertility is wanted. The purpose of this study was to evaluate the: cor relation between the pathological changes and the clinical characteristics on patients having torsion of the previously normal uterine adnexa which ma y help us decide whether detorsion is worthwhile. Method's. A retrospective study of 69 patients undergoing surgical interven tion for adnexal torsion was performed. Among them, 13 patients diagnosed w ith torsion of the previously normal adnexa were identified. Their clinical and pathological features were compared. Results. Extensive hemorrhagic necrosis of the twisted ovary was observed i n five patients, and each of them had their duration of torsion last 48 hou rs. or longer. Three of 13 cases (23.1%) with torsion of the previously nor mal adnexa had local thrombus formation within the twisted adnexa. Their du ration of torsion varied from 18 hours to 288 hours. Conclusions. The likelihood of preserving viable ovarian tissue is signific antly decreased if the duration of torsion lasts 48 hours or longer. Local thrombus formation in the twisted adnexa cannot be predicted simply from th e duration of torsion.