Clinical and Pathologic Evaluation of Adnexal Torsion Patients in Adolescence, Reproductive and Postmenopausal Periods

Year 2019, , 85 - 92, 28.08.2019

Bora Çoşkun , Burcu Timur , Buğra Çoşkun , Ferdi Kıncı Coşkun Şimşir

https://doi.org/10.19127/mbsjohs.559446

Cited By: 1

Abstract

Objective: The objective of our study was to compare the adnexal
torsion patients in different age groups clinically and pathologically.

Methods: Sixty-eight patients who had applied with pelvic pain
and adnexal torsion diagnosis had been confirmed intraoperatively were included
in the study. Patients were divided into three groups based on their ages as
the adolescent period (Group 1), reproductive period (Group 2) and postmenopausal
period (Group 3). Ages, history of torsion, history of past operations, periods
between the date of hospitalization and operation, periods of hospital stay,
adnexa as the localization of torsion and number of tours of torsion were
examined in groups. Mass lesions found during the operation and pathologic
consequences of such masses were examined retrospectively and compared.

Results: No statistically significant differences in torsion
history, past operations, WBC and platelet values, neutrophil/lymphocyte
ratios, preoperative fever, preoperative nausea and vomiting and preoperative
Doppler US findings between the groups included in the studies (p>0,05).
Although not statistically significant, WBC values were higher in the
postmenopausal patient group, and it was notable that symptoms including fever,
nausea and vomiting were absent in this group. The adolescent age group was the
group with the least confirmation of torsion diagnosis following the operation
with 13 (52%) patients. Upon evaluation of the operations carried out on
patients, it was seen that mostly fertility preserving approaches were preferred
for adolescent and reproductive patients with 88%, while more radical methods
such as USO (72.7%) and TAH+BSO (18.2%) were preferred in postmenopausal
patients. Ovarian tissue with torsion without any pathologic findings is more
frequent in the adolescent period as compared to other groups (48%). In the
postmenopausal period however, some pathology was found in the entire portion
of the adnexa with torsion. In the postoperative evaluation of the pathology
results of patients, no significant differences were observed as regards the
diameters of cysts (p:0,207). There are significant differences between the
histopathological types.

Conclusion: Although statistically significant differences have not
been observed as regards the clinic al presentation and laboratory findings
based on age groups; it must be kept in mind that a mass lesion can accompany
the torsion and the pathology of this mass can vary. Torsion must be remembered
in pelvic pain in the adolescent age group because of the indistinct clinical
findings and inadequacy of imaging methods.

Keywords

Adnexal Torsion, Pelvic Pain, Gyneacologic Emergency

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