Diagnosis and management of isolated tubal torsion: Is salpingectomy mandatory?

OBJECTIVE: To review the clinical characteristics of patients with isolated fallopian tube torsion (IFTT). STUDY DESIGN: We conducted a retrospective study of a consecutive series of IFTT cases presenting at 2 tertiary referral centers. All patients underwent laparoscopic assessment, and the fallopian tube and its ligamentous support were gently untwisted to assess ischemic lesions. Patients were classified based on the following 3 criteria: complete recovery (Group A), partial recovery (Group B), and without any recovery (Group C). RESULTS: Our series consisted of 9 patients. Group A (2 cases) and Group B (5 cases) were managed conservatively. Two patients were assigned to group C and underwent laparoscopic salpingectomy. During early postoperative period, in the conservatively managed group 4 patients underwent hysterosalpingography examination, and both fallopian tubes were found to be patent. One of these 4 patients had a spontaneous pregnancy and delivered a healthy infant, and another patient had a miscarriage at 6 weeks’ gestation. Imaging revealed no pathological findings in the remaining 3 virgins in the conservatively managed group. No infections, peritonitis, thromboembolic events, or other complications occurred during the follow-up period. CONCLUSION: Conservative management of IFTT can be considered a safe option, even if little evidence of recovery is observed after detorsion.