Laparoscopic detorsion allows sparing of the twisted ischemic adnexa

Study Objective. To determine the safety and outcome of laparoscopic detorsion in the management of the twisted ischemic, hemorrhagic adnexa. Design. Retrospective chart review and prospective follow-up (Canadian Task Force classification 11-2). Setting. University-affiliated hospital. Patients. Fifty-eight women with twisted black-bluish ischemic adnexa encountered at laparoscopy. Intervention. Laparoscopic detorsion with adnexal sparing. Measurements and Main Results. All patients had a benign immediate postoperative course. Transient temperature elevation occurred in seven women (12.1%). No signs of pelvic or systemic thromboembolism were detected in any patient. Long-term follow-up included transvaginal ultrasound, which revealed follicular development in the previously twisted adnexa in 54 women; normal macroscopic appearance at incidental subsequent surgery in 9; and in vitro fertilization with retrieval of oocytes from the previously twisted side in 4. Conclusion. Laparoscopic detorsion of the twisted ischemic hemorrhagic adnexa is a safe procedure with minimal postoperative morbidity and a potential for the ovary to recuperate fully with preservation of normal function. Laparoscopic adnexa-sparing procedures should be performed in place of traditional salpingo-oophorectomy in women with this disorder who desire future fertility.