Adnexal torsion
ICD-10 N83.5 · ICD-11 GA18.5

Treatment of Adnexal Torsion in Premenopausal Women

This protocol covers adnexal torsion in premenopausal patients, a setting where ovarian and fertility preservation are central clinical priorities and directly shape the management pathway.

Clinical Scenario

Premenopausal status defines a management context distinct from postmenopausal cases. Current consensus supports conservative surgical measures to preserve ovarian function and future reproductive potential — priorities that do not apply in the same way after menopause.

Treatment Approach (Partial)

Management centres on a laparoscopic surgical approach to the affected ovary, with conservative management favoured where the ovary remains viable. Depending on intraoperative findings, additional procedures may be considered during the same operation — the full protocol details the decision points and all options.

Clinical Goals

Detorsion of the ovary with prompt resolution of symptoms, and revascularisation with restoration of ovarian function in the affected ovary.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/tog.12985

  • Current consensus is that laparoscopic detorsion in pre-menopausal cases preserves ovarian function to support future pregnancy.
  • The management of OT differs significantly in postmenopausal patients compared to premenopausal; there is no prioritisation of hormonal or fertility preservation driving the need for conservative measures.
  • Unless there is true necrosis, there is likely a degree of ovarian function retained and so conservative management is favoured.
  • There is likely to be revascularisation and a return of ovarian function if conservatively managed.
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