Menstrual dysfunction as predictor of adnexal torsion in adolescent girls

Abstract

Menstrual dysfunction is characterised by high prevalence among female teenagers and in the future can lead to serious deviations in the reproductive health. In particular, it may indicate adnexal torsion. The frequency of the incidence and clinical manifestations of menstrual abnormalities were studied in young patients with adnexal torsion, as well as the optimization of surgical tactics for their treatment. Thirty-five teenage girls aged 13-17 undergone a comprehensive clinical, laboratory and instrumental examination were enrolled for the study. Group 1 included 21 patients with adnexal torsion, compromised by the presence of a retention ovarian cyst, while group 2 consisted of 14 patients with the torsion of intact adnexa. The patients were hospitalised with acute abdominal symptoms. After the examination, all patients were diagnosed with adnexal torsion. Analysis of the anamnestic data showed the impaired menstrual function in patients from group 1. Oligo-opsomenorrhea, secondary amenorrhea, and dysmenorrhea were registered. Pain syndrome with acute abdomen, as a rule, was preceded by a delay in menstruation due to the presence of a retention formation of the ovary. Menstrual dysfunction was not observed in patients from group 2 with the exception of a 15-year-old patient with a concomitant diagnosis of type I diabetes mellitus, later menarche, and oligomenorrhea. Torsion of intact adnexa could be due to the anatomical features of the internal genital organs and a more mobile way of life. Patients of both groups underwent 34 surgical interventions in the form of laparoscopy and 1 surgical interventions in the form of laparotomy with organ-preserving surgeries. In the absence of necrosis, detorsion was performed. Adnexal torsion is an urgent condition which requires emergency gynecological care. Menstrual irregularities as predictor of this condition can be observed in patients with compromised ovaries making it possible to timely diagnose the presence of retention formations and prevent complications, accompanied by acute abdomen. Keywords: adnexal torsion, girls, detorsion, menstrual dysfunction.