Abstract
Study Objective
Ovarian torsion (OT) is uncommon, but can result in loss of reproductive function.
Traditionally managed using adnexectomy, torsed adnexae are now being conserved, increasing
the potential for recurrent OT. As a result, some experts suggest oophoropexy (OP)
to prevent recurrence. We report on a series of 11 patients who underwent OP.
Design, Setting, Participants, Interventions, and Main Outcome Measures
A retrospective case series was conducted from 2004 to 2013 to identify patients younger
than the age of 18 years with OT. From this, data for patients with OP were extracted
for detailed review.
Results
We identified 97 patients with OT; 6 of 97 (6.2%) had recurrent OT. The rate of recurrence
was higher (14.8%, 4/27) in the group with torsion without an adnexal mass. Eleven
of 97 patients (11.3%) underwent OP. The mean age of patients with OP was 8.8 years.
Nine patients had normal adnexae at initial torsion. Five of 11 had OP during their
initial procedure. OP was most commonly performed for long utero-ovarian ligaments
(n = 6), recurrence (n = 4), or bilateral OT (n = 2). Eight of 8 patients with follow-up
ultrasound imaging after torsion showed at least 1 marker of normal ovarian function.
One of 11 patients (9%) had a recurrence of OT of an oophoropexied ovary. There were
no complications due to the OP portion of the procedure.
Conclusion
In our series of OT, a small percentage of patients underwent prophylactic OP. Recurrence
might still occur after OP. It seems reasonable to offer OP to patients at higher
risk of recurrent OT although level 1 evidence is lacking. Future research should
focus on techniques and long-term outcomes of OP.
Key Words
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Article info
Publication history
Published online: November 22, 2016
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
