title: Differentiated therapy in pre- and postmenopausal adnexal torsion based on malignancy rates: A retrospective multicentre study over five years.
abstract: BACKGROUND
  The purpose of this study was to investigate the clinical presentation, intra and postoperative outcomes in pre and postmenopausal women who underwent operations for adnexal torsion, and to define our experience diagnosing and managing postmenopausal women with adnexal torsion.
  
  
  METHODS
  One hundred and fifty-seven patients who underwent operation with a diagnosis of adnexal torsion were analyzed according to demographic characteristics, menopausal status, preoperative signs and symptoms, surgical findings and applied surgical procedures, and pathological results in four tertiary centers.
  
  
  RESULTS
  The main indication for surgery for the postmenopausal women was pelvic mass (58% vs. 40%), while for premenopausal women the main indication was suspicion of torsion (55% vs. 24%), (each p < 0.001). The duration of time between being admitted to the hospital and entering operating room as well as the duration of surgery and postoperative hospitalization were statistically longer in the postmenopausal group (each p < 0.001). While extensive surgeries were performed for 68% of the postmenopausal group, this was required for only 3% of the premenopausal group. Functional cysts were the most common pathologic finding in premenopausal women, and only 2 cases of malignancy (1.6%) were seen as opposed to the postmenopausal group, where malignancy was diagnosed in 16% of cases (p < 0.001).
  
  
  CONCLUSIONS
  Adnexal torsion in postmenopausal women is an uncommon event. Malignancy risk should be considered before operation.
  
  
  CONCLUSIONS
  The malignancy rate was 16% in postmenopausal women with adnexal torsion. Thus, extensive surgeries are more common in postmenopausal women with adnexal torsion.
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Research and Training Hospital, Izmir, Turkey. Electronic address: opdraykutozcan@gmail.com.
authors.forename: Aykut
authors.initials: A
authors.lastname: Ozcan
authors.affiliation: Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Sezcan
authors.initials: S
authors.lastname: Mumusoglu
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gokcu
authors.affiliation: Department of Obstetrics and Gynecology, Bakırköy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: Sema Süzen
authors.initials: SS
authors.lastname: Caypinar
authors.affiliation: Department of Obstetrics and Gynecology, Yeni Yuzyil University School of Medicine, GOP Hospital, Istanbul, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Sagiroglu
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Abdurrahman Hamdi
authors.initials: AH
authors.lastname: Inan
authors.affiliation: Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Aktoz
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Biler
authors.affiliation: Department of Obstetrics and Gynecology, Yeni Yuzyil University School of Medicine, GOP Hospital, Istanbul, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Turan
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Töz
authors.affiliation: Department of Obstetrics and Gynecology, Bakırköy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: Isa Aykut
authors.initials: IA
authors.lastname: Ozdemir
authors.affiliation: Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Gurkan
authors.initials: G
authors.lastname: Bozdag
mesh_terms: D000291:Adnexal Diseases / Q000150:complications / Q000601:surgery*; D000328:Adult; D000368:Aged; D003560:Cysts / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D010386:Pelvic Neoplasms / Q000209:etiology / Q000601:surgery; D017698:Postmenopause; D017697:Premenopause; D012189:Retrospective Studies; D012307:Risk Factors; D014102:Torsion Abnormality / Q000150:complications / Q000601:surgery*; D055815:Young Adult
keywords: Extensive surgery; Ovarian cancer; Ovarian torsion; Postmenopausal women