ARCHIVEOBSTETRICS AND GYNECOLOGY
International Medical Journal, Vol. 20., Iss. 4, 2014, P. 37−40.
MODERN APPROACH TO THE PROBLEM OF OVARIAN TORSION IN WOMEN OF REPRODUCTIVE AGE
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Acute gynecological diseases are responsible for 1−26 % of hospitalization to gynecology hospitals. Twisting of uterus appendages occupies the fifth place among urgent gynecological pathology among the patients with acute abdomen. Teenagers with benign tumors and tumorous formations of uterus appendages, women of reproductive age with infertility who underwent hyperstimulation as well as pregnant women suffer from this pathology. The larger the sizes of the ovary, the more probability is its twisting. The clinical picture of ovary twisting is determined by the degree of the circulation disorder. Conservative treatment is possible when ovary twisting is partial. One of the methods of conservative treatment of ovary cyst twisting is abdominal aspiration of the cyst under ultrasound control and changing of the body position representing a wise alternative to surgical intervention during pregnancy. Treatment of total twisting of benign tumors or tumor−like formations is carried out with the use of laparoscopic or laparotomic access. Modern approaches to surgical treatment depend on the findings of the additional methods of research including Doppler ultrasound, computed tomography, magnetic resonance imaging, interleikin−6 testing. The data of the pregnancy outcome in patients with ovary twisting are shown. Thus, ovary twisting is an important problem in gynecology due to the increase of the number of patients with benign tumors and tumor−like formations and their twisting leads to reduction of reproductive function, as a result only 60 % of patients have a timely childbirth. Therefore, development of new methodologies of laparoscopic access and applying of medication aimed at ovarian circulation normalization after twisting elimination is an urgent issue of modern gynecology.
Key words: ovarian torsion, diagnosis, laparoscopic and combination treatment.