Effect of Surgical Intervention Timing on Ovarian Viability in Adnexal Torsion: A Cross-Sectional Study

Abstract

Background : Torsion is a condition that affects the adnexa completely or partially and causes circulatory disorders in the ovary. To the best of our knowledge, it is unclear how long it takes for the damage to the ovary during the torsion process to become irreversible. The aim of our study was to evaluate the pathology results and ovarian ischemia status of patients who underwent surgery with the indication of adnexal torsion in our clinic, and to determine the relationship between operation timing, and ovarian viability. Methods : The study was conducted retrospectively in the department of gynecology and obstetrics at Dokuz Eylul University Hospital between April 2023 and October 2023. Cases who presented to our clinic with acute abdominal pain and decided to undergo surgery due to suspicion of torsion were included in the study. Patients who were decided to undergo surgery within 6 hours after the onset of symptoms constituted group 1 (n = 26), and patients who were decided to undergo surgery after 6 hours after the onset of symptoms constituted group 2 (n = 36). Statistical analyses were conducted using IBM SPSS Statistics version 26.0 (IBM Inc., Chicago, IL, USA). Results : The average age of the patients in group 1 was significantly lower than that in group 2 ( p < 0.001). When both groups were compared, the rate of previous torsion history in group 1 was found significantly higher than that in group 2 ( p = 0.04). When both groups were compared in terms of laboratory and imaging findings, no difference was detected between the groups. When both groups were compared in terms of torsion type, ligamentopexy application, torsion area, and torsion direction, no difference was found between the groups. The surgery time in group 2 was found significantly longer than that in group 1 ( p < 0.0001). When both groups were compared in terms of intraoperative necrosis, no significant difference was found between the groups ( p = 0.3). Conclusions : With the current data, there is no definitive time limit for the effect of the timing of surgical intervention on ovarian viability in adnexal torsion.