Oxidative stress during ovarian torsion in pediatric and adolescent patients: Changing the perspective of the disease

Antonio Simone Laganà, Vincenza Sofo, Francesca Maria Salmeri, Vittorio Italo Palmara, Onofrio Triolo, Milan Milosav Terzić, Tito Silvio Patrelli, Adolf Lukanovic, Eda Vrtcnik Bokal, Giuseppe Santoro

Research output: Contribution to journalReview article

20 Citations (Scopus)

Abstract

Among the different causes of gynecological acute pelvic pain, ovarian torsion represents a surgical emergency. It is a rare case in the pediatric/adolescent aged group that must be included in the differential diagnosis of any girl with abdominal pain or pelvic/abdominal mass. Current recommendations suggest that laparoscopic detorsion should be performed in order to preserve the integrity of the ovaries and fertility, although oophoropexy may be considered in case of severe necrosis. Nevertheless, maintaining the circulation of the ovary after detorsion deteriorates the tissue injury and leads to a pathologic process called ischaemia/reperfusion (I/R) injury, which is characterized by oxidative stress. During the detorsion process, an excess amount of molecular oxygen is supplied to the tissues, and reactive species of oxygen (ROS) such as superoxide radical (O2 -), hydrogen peroxide (H2O2), hydroxyl radical (OH•), as well as reactive nitrogen species (RNS) are produced in excess. ROS, RNS and their toxic products cause DNA damage and lipid peroxidation in the cellular and mitochondrial membranes, leading to cell death. In spite of attention on this topic, currently there is no shared and clear evidence about the use of anti-inflammatory and antioxidant agents to prevent I/R damage after laparoscopic ovarian detorsion. Considering this element, future research should aim to develop shared protocols for the clinical use (route of application, dosage and time of application) of antioxidants after laparoscopic management of this condition.

Original languageEnglish
Pages (from-to)416-423
Number of pages8
JournalInternational Journal of Fertility and Sterility
Volume9
Issue number4
Publication statusPublished - Jan 1 2015
Externally publishedYes

Keywords

  • Adolescents
  • Antioxidants
  • Ischaemia
  • Oxidative stress
  • Paediatrics
  • Reperfusion

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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    Laganà, A. S., Sofo, V., Salmeri, F. M., Palmara, V. I., Triolo, O., Terzić, M. M., Patrelli, T. S., Lukanovic, A., Bokal, E. V., & Santoro, G. (2015). Oxidative stress during ovarian torsion in pediatric and adolescent patients: Changing the perspective of the disease. International Journal of Fertility and Sterility, 9(4), 416-423.