LAUSR

OBJECTIVE To review our institutional data regarding the management of adnexal torsion (AT) and assess the ovarian conservation rates. DESIGN Retrospective study SETTING: Tertiary Children's Hospital PATIENTS: Paediatric and adolescent patients with surgically diagnosed AT. Participants (n=54, mean age 9.80 ± 3.95 years) were identified between June 2010 to May 2019. INTERVENTIONS Surgical management of adnexal AT. MEASUREMENTS The primary outcome was to determine the ovarian conservation rates in AT cases. The secondary outcomes were to determine the incidence of AT to total Emergency Department (ED) presentations, decision to operation theatre (OT) time in AT cases, return to OT, histopathology and follow-up with ultrasound to determine ovarian function. Data were collected on demographic and clinical characteristics. Continuous data were compared with t- or Kruskal-Wallis tests; categorical data were compared with Chi-Square test. MAIN RESULTS 52 patients (96.3%) had ovarian conservation. 53 (98%) had laparoscopic management. Incidence rate for AT cases to total ED presentations for the last 10 years was 9.9/100,000 which were based on a Poisson distribution. Presentations to ED for AT cases have trended upwards since 2010. Decision to OT time was statistically significantly shorter in cases with preoperative suspicion of AT as compared to those with intraoperative diagnosis of AT (P=000). 7 (12.9%) returned to OT for suspicion of recurrent torsion. 5 (9.2%) of these had confirmed repeat AT. The presence of fever, pain duration, severity of pain and severity of torsion did not correlate with the follow up USS findings of ovarian activity. CONCLUSION The findings from our study suggests that high ovarian conservation rates are achievable in adnexal torsion cases. High index of suspicion is required to prevent delay in surgery.