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 language | English |
|---|---|
| Pages (from-to) | 416-423 |
| Number of pages | 8 |
| Journal | International Journal of Fertility and Sterility |
| Volume | 9 |
| Issue number | 4 |
| Publication status | Published - Jan 1 2015 |
| Externally published | Yes |
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Keywords
- Adolescents
- Antioxidants
- Ischaemia
- Oxidative stress
- Paediatrics
- Reperfusion
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology
Cite this
Oxidative stress during ovarian torsion in pediatric and adolescent patients : Changing the perspective of the disease. / Laganà, Antonio Simone; Sofo, Vincenza; Salmeri, Francesca Maria; Palmara, Vittorio Italo; Triolo, Onofrio; Terzić, Milan Milosav; Patrelli, Tito Silvio; Lukanovic, Adolf; Bokal, Eda Vrtcnik; Santoro, Giuseppe.
In: International Journal of Fertility and Sterility, Vol. 9, No. 4, 01.01.2015, p. 416-423.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Oxidative stress during ovarian torsion in pediatric and adolescent patients
T2 - Changing the perspective of the disease
AU - Laganà, Antonio Simone
AU - Sofo, Vincenza
AU - Salmeri, Francesca Maria
AU - Palmara, Vittorio Italo
AU - Triolo, Onofrio
AU - Terzić, Milan Milosav
AU - Patrelli, Tito Silvio
AU - Lukanovic, Adolf
AU - Bokal, Eda Vrtcnik
AU - Santoro, Giuseppe
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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.
KW - Adolescents
KW - Antioxidants
KW - Ischaemia
KW - Oxidative stress
KW - Paediatrics
KW - Reperfusion
UR - http://www.scopus.com/inward/record.url?scp=84983157125&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84983157125&partnerID=8YFLogxK
M3 - Review article
VL - 9
SP - 416
EP - 423
JO - International Journal of Fertility and Sterility
JF - International Journal of Fertility and Sterility
SN - 2008-076X
IS - 4
ER -