V.F.Snegirev Archives of Obstetrics and GynecologyV.F.Snegirev Archives of Obstetrics and Gynecology2313-87262687-1386Eco-Vector3533510.18821/2313-8726-2016-3-2-108-112Research ArticleTactics of the surgical treatment of torsion of the SINGLE uterine appendages in nulliparous womenIshchenkoAnatoly I.MD, PhD, DSci, Professor, Head of the Department of Obstetrics and Gynecology of the I.M. Sechenov First Moscow State Medical University7205502@mail.ruIshchenkoA. A-BakhvalovaA. A-DevitskiyA. A-MaksimovA. I-I.M. Sechenov First Moscow State Medical University150620163210811221072020Copyright © 2016, Eco-Vector2016There are considered two clinical cases of torsion of the single uterine appendages in patients of reproductive age without pregnancies in a history. Both patients previously were undergone to adnexectomy due to adnexal torsion. After clinical and laboratory examination and intraoperative endoscopic visualization of the pelvic organs it was decided advisory to limit the amount of surgical intervention by means of unwinding the uterus by laparoscopic method. Taking into account the adnexal torsion on the opposite side (with subsequent adnexectomy) in a history the main stage of the surgical treatment was supplemented by ovariopexy to prevent disease recurrence. Postoperative control for the restoration of blood supply to the ovarian tissues includes programmed laparoscopic examination, monochrome ultrasound scanning, color Doppler mapping (CDM), the study of blood levels of sex hormones, a common clinical and biochemical analyzes of blood, coagulogram.single torsion of the uterusnulliparous womensurgeryперекрут единственных придатков маткинерожавшие женщиныхирургическое лечение[Anders J.F., Powell E.C. Urgency of evaluation and outcome of acute ovarian torsion in pediatric patients. Arch. Pediatr. Adolesc. Med. 2005; 159(6): 532-5.][Argenta P.A., Yeagley T.J., Ott G., Sondheimer S.J. Torsion of the uterine adnexa. Pathologic correlations and current management trends. J. Reprod. Med. 2000; 45: 831-6.][Bider D., Ben-Rafael Z., Goldenberg M. Pregnancy outcome after unwinding of twisted ischaemic-haemorrhagic adnexa. Br. J. Obstetr. Gynaecol. 1989; 96(4): 428-30.][Breech L.L., Hillard P.J.A. Adnexal torsion in pediatric and adolescent girl. Curr. Opin. Obstetr. Gynecol. 2005; 17: 483-7.][Canis M., Manhes H., Wattiez A., Mage G., Pouly J.L., Bruhat M.A. Long-term follow-up after conservative laparoscopic management of adnexal torsion. In: Abstracts of the 18th Annual Meeting of the ESHRE. Vienna; 2002.][Ements M., Doornewaard H., Admiraal J.C. Adnexal torsion in very young girls: Diagnostic pitfalls. Eur. J. Obstetr. Reprod. Biol. 2004; 116: 207-10.][Germain M., Rarick T., Robins E. Management of intermittent ovarian torsion by laparoscopic oophoropexy. Obstetr. And Gynecol. 1996; 88(4, Pt 2): 715-7.][Hibbard L.T. Adnexal torsion. Am. J. Obstetr. Gynecol. 1985; 152(4): 456-61.][Houry D., Abbott J.T. Ovarian torsion: a fifteen-year review. Ann. Emerg. Med. 2001; 38(2): 156-9.][Lee E.J., Kwon H.C., Joo H.J. Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J. Ultrasound Med. 1998; 17(2): 83-9.][Oelsner G., Shashar D. Adnexal torsion. Clin. Obstetr. Gynecol. 2006; 49(3): 459-63.][Panayotidis C., Nisolle M. Recent advances of laparoscopic approach in adnexal torsion of premenarcheal girl. Gynecol. Surg. 2007; 4: 155-60.][Peterson W.F., Prevost E.C., Edmunds F.T., Hundley J.M. Jr, Morris F.K. Benign cystic teratomas of the ovary; a clinico-statistical study of 1,007 cases with a review of the literature. Am. J. Obstetr. Gynecol. 1955; 70: 368-82.][Sommerville M., Grimes D.A., Koonings P.P., Campbell K. Ovarian neoplasms and the risk of adnexal torsion. Am. J. Obstetr. Gynecol. 1991; 164(2): 577-8.][Steyaert H., Meynol F., Valla J.S. Torsion of the adnexa in children: value of laparoscopy. Pediatr. Surg. Int. 1998; 13: 384-4.][Warner M.A., Fleischer A.C., Edell S.L. et al. Uterine adnexal torsion: sonographic findings. Radiology. 1985; 154(3): 773-5.][Yiu-Tai Li, Lung-Ching Kuon, Po-Ning Lee, Tsung-Cheng Kuo. Laparoscopic detorsion of twisted ovary. J. Chin. Med. Assoc. 2005; 68: 595-8.][Хирш Х.A., Казер O., Икле Ф.A. Оперативная гинекология: Атлас. Пер. с англ. М.: ГЭОТАР-Медиа; 1999.][Айламазян Э.К., Рябцева И.Т. Неотложная помощь при экстренных состояниях в гинекологии. М.: Медкнига; 2003.][Поддубный И.В., Дьяконова Е.Ю., Глыбина Т.М., Исаев А.А., Короткова С.А. Повторная лапароскопия после деторсии нормальных придатков матки у девочек. Тезисы VIII Съезда Российского общества эндохирургов. М.; 2005: тез. 116.]