# Drainage by Ovarian Incision for the Treatment of Massive Ovarian Edema Torsion During Pregnancy

## TL;DR

This paper presents a rare case of massive ovarian edema torsion during pregnancy and describes a successful treatment using laparoscopic surgery with detorsion and drainage.

## Contribution

The paper introduces a novel laparoscopic treatment approach for MOE torsion during pregnancy involving drainage via ovarian incision.

## Key findings

- Laparoscopic detorsion and drainage via ovarian incision preserved the ovary and prevented recurrence during pregnancy.
- The patient delivered a healthy baby at 39 weeks without complications.
- This is the third reported case of MOE after clomiphene citrate-induced ovulation.

## Abstract

Massive ovarian edema (MOE) is a rare benign condition presenting as unilateral ovarian enlargement with stromal edema, and only a limited number of MOE cases during pregnancy have been reported. MOE is often complicated by ovarian torsion, which requires detorsion. Although the diagnosis of MOE can be made using ultrasound and magnetic resonance imaging, its rarity makes diagnosis difficult, usually leading to overtreatment. Preserving the ovary in the treatment of MOE torsion is essential, and consideration of oophoropexy after detorsion is often reported. However, fixing an enlarged ovary to the pelvic wall in the limited space of the pelvis is challenging.

Herein, we present a case of MOE of the right ovary diagnosed at the fifth week of gestation after ovulation induced by clomiphene citrate. Torsion of the ovary occurred in the seventh week. We achieved preservation of the ovary through laparoscopic surgery with detorsion and drainage by making a small incision to the enlarged ovary, resulting in an immediate size reduction. There was no recurrence of torsion or MOE throughout the pregnancy, and the patient gave birth in the 39th week of gestation. This is the third reported case of MOE after ovulation using clomiphene citrate, and it highlights the effectiveness of treatment with detorsion and a small incision of the ovary via laparoscopic surgery in patients with MOE torsion during pregnancy.