Quando a intervenção cirúrgica ocorre em tempo hábil, o prognóstico é considerado excelente, com a devida manutenção da função ovariana. Com procedimentos minimamente invasivos, como a laparoscopia e a destorção de anexos, espera-se a completa recuperação da função ovariana normal e da fertilidade.[58]Yasa C, Dural O, Bastu E, et al. Impact of laparoscopic ovarian detorsion on ovarian reserve. J Obstet Gynaecol Res. 2017 Feb;43(2):298-302.
http://www.ncbi.nlm.nih.gov/pubmed/27928855?tool=bestpractice.com
[59]Geimanaite L, Trainavicius K. Ovarian torsion in children: management and outcomes. J Pediatr Surg. 2013 Sep;48(9):1946-53.
http://www.ncbi.nlm.nih.gov/pubmed/24074673?tool=bestpractice.com
[60]Balasubramaniam D, Duraisamy KY, Ezhilmani M. Laparoscopic detorsion and fertility preservation in twisted ischemic adnexa - a single-center prospective study. Gynecol Minim Invasive Ther. 2020 Jan 23;9(1):24-8.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008646
http://www.ncbi.nlm.nih.gov/pubmed/32090009?tool=bestpractice.com
Fertilidade
Muitos estudos evidenciam a função ovariana subsequente do ovário acometido.[3]Oelsner G, Shashar D. Adnexal torsion. Clin Obstet Gynecol. 2006 Sep;49(3):459-63.
http://www.ncbi.nlm.nih.gov/pubmed/16885653?tool=bestpractice.com
[20]Bider D, Mashiach S, Dulitzky M, et al. Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women. Surg Gynecol Obstet. 1991 Nov;173(5):363-6.
http://www.ncbi.nlm.nih.gov/pubmed/1948585?tool=bestpractice.com
[58]Yasa C, Dural O, Bastu E, et al. Impact of laparoscopic ovarian detorsion on ovarian reserve. J Obstet Gynaecol Res. 2017 Feb;43(2):298-302.
http://www.ncbi.nlm.nih.gov/pubmed/27928855?tool=bestpractice.com
[61]Mashiach S, Bider D, Moran O, et al. Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy. Fertil Steril. 1990 Jan;53(1):76-80.
http://www.ncbi.nlm.nih.gov/pubmed/2295348?tool=bestpractice.com
[65]Ben-Rafael Z, Bider D, Mashiach S. Laparoscopic unwinding of twisted ischemic hemorrhagic adnexum after in vitro fertilization. Fertil Steril. 1990 Mar;53(3):569-71.
http://www.ncbi.nlm.nih.gov/pubmed/2137796?tool=bestpractice.com
[68]Cohen SB, Wattiez A, Seidman DS, et al. Laparoscopy versus laparotomy for detorsion and sparing of twisted ischemic adnexa. JSLS. 2003 Oct-Dec;7(4):295-9.
http://www.ncbi.nlm.nih.gov/pubmed/14626393?tool=bestpractice.com
[74]Descargues G, Tinlot-Mauger F, Gravier A, et al. Adnexal torsion: a report on forty-five cases. Eur J Obstet Gynecol Reprod Biol. 2001 Sep;98(1):91-6.
http://www.ncbi.nlm.nih.gov/pubmed/11516806?tool=bestpractice.com
[75]Shalev E, Mann S, Romano S, et al. Laparoscopic detorsion of adnexa in childhood: a case report. J Pediatr Surg. 1991 Oct;26(10):1193-4.
http://www.ncbi.nlm.nih.gov/pubmed/1838120?tool=bestpractice.com
Em um estudo, a função ovariana retornou em 93% das pacientes.[3]Oelsner G, Shashar D. Adnexal torsion. Clin Obstet Gynecol. 2006 Sep;49(3):459-63.
http://www.ncbi.nlm.nih.gov/pubmed/16885653?tool=bestpractice.com
[68]Cohen SB, Wattiez A, Seidman DS, et al. Laparoscopy versus laparotomy for detorsion and sparing of twisted ischemic adnexa. JSLS. 2003 Oct-Dec;7(4):295-9.
http://www.ncbi.nlm.nih.gov/pubmed/14626393?tool=bestpractice.com
Esses resultados se replicam em crianças tratadas de maneira conservadora para torção ovariana.[17]Cass DL. Ovarian torsion. Semin Pediatr Surg. 2005 May;14(2):86-92.
http://www.ncbi.nlm.nih.gov/pubmed/15846564?tool=bestpractice.com
[57]Dasgupta R, Renaud E, Goldin AB, et al. Ovarian torsion in pediatric and adolescent patients: a systematic review. J Pediatr Surg. 2018 Jul;53(7):1387-91.
http://www.ncbi.nlm.nih.gov/pubmed/29153467?tool=bestpractice.com
[59]Geimanaite L, Trainavicius K. Ovarian torsion in children: management and outcomes. J Pediatr Surg. 2013 Sep;48(9):1946-53.
http://www.ncbi.nlm.nih.gov/pubmed/24074673?tool=bestpractice.com
[75]Shalev E, Mann S, Romano S, et al. Laparoscopic detorsion of adnexa in childhood: a case report. J Pediatr Surg. 1991 Oct;26(10):1193-4.
http://www.ncbi.nlm.nih.gov/pubmed/1838120?tool=bestpractice.com
[76]Templeman C, Hertweck SP, Fallat ME. The clinical course of unresected ovarian torsion. J Pediatr Surg. 2000 Sep;35(9):1385-7.
http://www.ncbi.nlm.nih.gov/pubmed/10999708?tool=bestpractice.com
Recorrência
O risco exato de torção ovariana ipsilateral ou contralateral assíncrona recorrente não é conhecido. Parece variar de 2% a 5%.[18]Beaunoyer M, Chapdelaine J, Bouchard S, et al. Asynchronous bilateral ovarian torsion. J Pediatr Surg. 2004 May;39(5):746-9.
http://www.ncbi.nlm.nih.gov/pubmed/15137011?tool=bestpractice.com
[67]Oelsner G, Cohen SB, Soriano D, et al. Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Hum Reprod. 2003 Dec;18(12):2599-602.
http://humrep.oxfordjournals.org/content/18/12/2599.full
http://www.ncbi.nlm.nih.gov/pubmed/14645177?tool=bestpractice.com
A recorrência é mais comum nas crianças sem patologias subjacentes encontradas durante a cirurgia para torção ovariana, com o risco em relatado de 2% a 35%.[17]Cass DL. Ovarian torsion. Semin Pediatr Surg. 2005 May;14(2):86-92.
http://www.ncbi.nlm.nih.gov/pubmed/15846564?tool=bestpractice.com
[18]Beaunoyer M, Chapdelaine J, Bouchard S, et al. Asynchronous bilateral ovarian torsion. J Pediatr Surg. 2004 May;39(5):746-9.
http://www.ncbi.nlm.nih.gov/pubmed/15137011?tool=bestpractice.com
[77]Smorgick N, Melcer Y, Sarig-Meth T, et al. High risk of recurrent torsion in premenarchal girls with torsion of normal adnexa. Fertil Steril. 2016 Jun;105(6):1561-5.e3.
http://www.ncbi.nlm.nih.gov/pubmed/26926251?tool=bestpractice.com
Na recorrência de torção, o tratamento é o mesmo.