Abstract
Purpose
Recurrence of adnexal torsion involving otherwise normal adnexa is not rare. Various oophoropexy (ovarian fixation) procedures have been suggested to prevent recurrence; however, long-term information of their efficacy is lacking. The aim of this study was to investigate the recurrence rate of adnexal torsion following oophoropexy.
Methods
Retrospective cohort study, including all consecutive patients who underwent an oophoropexy procedure for the prevention of recurrent torsion of “normal adnexa” in our department from 2008 to 2019 by shortening of the utero-ovarian ligament.
Results
Nineteen patients (age range 7–35 years) with a mean follow-up of 90.9 ± 57.7 months were identified. Fifteen of them (78.9%) were re-operated for recurrent torsion following an oophoropexy procedure, while four (21.1%) did not experience recurrence. Nine torsion recurrences following an oophoropexy occurred within the first 2 postoperative years. There were no differences in mean age and menarcheal status )pre- or post-menarcheal) at the time of the first torsion event, age at the time of oophoropexy, oophoropexy side, number of adnexal torsion events before oophoropexy, and follow-up duration between those with and those without post-oophoropexy recurrences.
Conclusion
Oophoropexy procedure by shortening of the utero-ovarian ligament may not prevent recurrent torsion of otherwise normal adnexa. Further studies to determine whether combined fixation (utero-ovarian and round ligament plication) is more efficacious than isolated utero-ovarian plication for the prevention of recurrent torsion are warranted.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Melcer Y, Sarig-Meth T, Maymon R, Pansky M, Vaknin Z, Smorgick N (2016) Similar but different: a comparison of adnexal torsion in pediatric, adolescent, and pregnant and reproductive-age women. J Womens Health (Larchmt) 25:391–396
Tsafrir Z, Hasson J, Levin I, Solomon E, Lessing JB, Azem F (2012) Adnexal torsion: cystectomy and ovarian fixation are equally important in preventing recurrence. Eur J Obstet Gynecol Reprod Biol 162:203–205
Pansky M, Smorgick N, Herman A, Schneider D, Halperin R (2007) Torsion of normal adnexa in postmenarcheal women and risk of recurrence. Obstet Gynecol 109:355–359
Smorgick N, Melcer Y, Sarig-Meth T, Maymon R, Vaknin Z, Pansky M (2016) High risk of recurrent torsion in premenarcheal girls with torsion of normal adnexa. Fertil Steril 105:1561–5.e3
Raicevic M, Saxena AK (2017) Asynchronous bilateral ovarian torsions in girls-systematic review. World J Pediatr 13:416–420
Fuchs N, Smorgick N, Tovbin Y, Ben Ami I, Maymon R, Halperin R, Pansky M (2010) Oophoropexy to prevent adnexal torsion: how, when, and for whom? J Minim Invasive Gynecol 17:205–208
Weitzman VN, DiLuigi AJ, Maier DB, Nulsen JC (2008) Prevention of recurrent adnexal torsion. Fertil Steril. https://doi.org/10.1016/j.fertnstert.2008.02.144
Obut M, Değer U (2019) A new technique of oophoropexy: folding and fixating of utero-ovarian ligament to round ligament in a patient with recurrent ovarian torsion. Case Rep Obstet Gynecol 2019:7647091
Simsek E, Kilicdag E, Kalayci H, Yuksel Simsek S, Parlakgumus A (2013) Repeated ovariopexy failure in recurrent adnexal torsion: combined approach and review of the literature. Eur J Obstet Gynecol Reprod Biol 170:305–308
Comeau IM, Hubner N, Kives SL, Allen LM (2017) Rates and technique for oophoropexy in pediatric ovarian torsion: a single-institution case series. J Pediatr Adolesc Gynecol 30:418–421
Funding
The authors declare that no funds, grants, or other support was received during the preparation of this manuscript.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation was performed by NS, NE and MND. Data collection was performed by NS and MM. Data analysis was performed by NS and ZV. The first draft of the manuscript was written by NS. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no relevant financial or non-financial interests to disclose.
Ethical approval
The study was approved by the institutional Review Board (#0332-19-ASF, approved on September 2nd, 2020) which waived informed consent for this retrospective review of medical records.
Informed consent
Oral informed consent was obtained from all patients who were contacted by telephone for the acquisition of follow-up information.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Smorgick, N., Mor, M., Eisenberg, N. et al. Recurrent torsion of otherwise normal adnexa: oophoropexy does not prevent recurrence. Arch Gynecol Obstet 307, 821–825 (2023). https://doi.org/10.1007/s00404-022-06831-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-022-06831-7