Laparoscopic management of a large torted ovarian cyst in an adolescent virgin: a case report

Abstract

Mohamed Sabry,1,2 Abdou S Ait Allah,1 Eman Roshdy,2,3 Ayman Al-Hendy21Department of Obstetrics and Gynecology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt; 2Department of Obstetrics and Gynecology, Center for Women’s Health Research, Meharry Medical College, Nashville, TN, USA; 3Department of Public Health and Community Medicine, Sohag Faculty of Medicine, Sohag University, Sohag, EgyptAbstract: We report a case of a torted mature cystic teratoma in a 23-year-old, sexually inactive, virgin female which necessitated immediate laparoscopy. The patient and her family stressed that the integrity of the hymen must be maintained at any cost, for cultural reasons. We opted out of our routine intravaginal preparation for laparoscopic surgery to honor the patient’s request to maintain the integrity of the hymen. Left salpingo-oophorectomy was accomplished, and the specimen was removed using a large nephrectomy endobag. Here, we describe techniques that are useful for this procedure, including the use of gauze attached to ovum forceps to manipulate the uterus through the rectum, and a review of the literature.Keywords: ovarian teratoma, large torted cyst, virgin female, laparoscopic management, cultural sensitivity, treatment option