Oophoropexy to the Round Ligament after Recurrent Adnexal Torsion

Gonçalves, Isabelle Perez Ramirez; Sampaio, J.; Félix, Joana; Silva, Ana Catarina; Fornelos, Gisela; Silva, Pedro Tiago

doi:10.1055/s-0038-1673426

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…Several oophoropexy techniques have been reported, such as fixation of the ovary to the pelvic side wall, the posterior uterine wall, the sacro-uterine ligament, the posterior abdominal wall, and the ligamentum teres uteri both with and without plication of the utero-ovarian ligament [6, 10, 12, 19, 20]. The best management strategy of recurrent ovarian torsion is still under debate, and no clear answer exists regarding patient selection, timing, the preferred surgical method, and whether the procedure should be performed bilaterally or unilaterally [7, 17].…”

Section: Discussionmentioning

confidence: 99%

A New Technique of Oophoropexy: Folding and Fixating of Utero-Ovarian Ligament to Round Ligament in a Patient with Reccurrent Ovarian Torsion

Obut

Değer

2019

Case Reports in Obstetrics and Gynecology

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Introduction Most cases of ovarian torsion occur in the reproductive age and many are related to ovarian and paraovarian masses. If it occurs without any subtle anatomic etiology or ovarian and paraovarian masses, recurrence of ovarian torsion is more likely. Recurrent left ovarian torsion is much less common than recurrent right ovarian torsion. The authors describe a rare case with their new ovarian fixation technique. Case and Method A 21-year-old female patient with polycystic ovarian syndrome had a 7th recurrence of left ovarian torsion. Although ovarian fixation was performed in addition to detorsion at the 5th and the 6th laparoscopic surgeries, it had failed. Due to recurrence ovarian torsion after ovarian fixation, the authors performed a different technique:folding the utero-ovarian ligament which folded on itself. The distal part of the utero-ovarian ligament with the ovary was both fixed to the proximal part of the round ligament which was adjacent to the uterus. Conclusion Although a wide range of oophoropexy methods have been described in the literature, the best method remains a matter for debate. This technique can be performed even when the ovarian tissue is necrotic. Because of this, we think that this technique is useful and effective technique.

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Section: Discussionmentioning

confidence: 99%

A New Technique of Oophoropexy: Folding and Fixating of Utero-Ovarian Ligament to Round Ligament in a Patient with Reccurrent Ovarian Torsion

Obut

Değer

2019

Case Reports in Obstetrics and Gynecology

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“…An ovary that was necrotic and hemorrhagic was found during anatomopathological analysis. Consequently, the patient exhibited no further signs of a recurrence of contralateral ovarian torsion [ 26 ].…”

Section: Ovarian Torsion In Polycystic Ovary Syndromementioning

confidence: 99%

Ovarian Torsion in Polycystic Ovary Syndrome: A Potential Threat?

Psilopatis,

Damaskos,

Garmpis

et al. 2023

Biomedicines

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Polycystic ovary syndrome (PCOS) constitutes the most prevalent endocrine disorder in women of reproductive age worldwide. Given the increased risk of ovarian torsion in the presence of large ovarian cysts, polycystic ovarian syndrome could be regarded as one of the most significant risk factors for ovarian and/or adnexal torsion in cases of significantly enlarged ovaries. The aim of the present review is to investigate, for the first time, the association between polycystic ovarian syndrome and ovarian torsion. We performed a review of the literature using the MEDLINE and LIVIVO databases in order to find relevant studies. By using the search terms “polycystic ovarian syndrome” and “ovarian torsion”, we were able to identify 14 studies published between 1995 and 2019. The present work constitutes the most up-to-date, comprehensive literature review focusing on the risk of ovarian/adnexal torsion in patients with polycystic ovaries. Ovarian/adnexal torsion seems to be a feared complication in patients with polycystic ovary syndrome. Acute lower abdominal pain in patients with known polycystic ovaries represents the most common symptom, while diagnostic assessment almost always incorporates transvaginal ultrasound and computer tomography or magnetic resonance tomography scans. In case of suspected torsion, emergency laparoscopy with ovarian or adnexal detorsion seems to be the standard therapeutic approach with a view to restitute the interrupted blood supply. In cases of repeated ovarian/adnexal torsions, ovariopexy or ovariectomy/adnexectomy had to be discussed with the patient in the context of risk recurrence minimization.

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“…Oophoropexy has been described as a preventive intervention to decrease the risk of recurrent torsion. Various techniques have been described, including plication of the utero-ovarian ligament, suturing the ovary to the round ligament or the posterior uterus, or pelvic sidewall [52][53][54]. Small studies have shown success with fertility and normal appearance of ovaries on follow-up ultrasound, but long-term effects of oophoropexy on recurrence rates and fertility are not known [52].…”

Section: Treatmentmentioning

confidence: 99%

Adnexal torsion: a review of diagnosis and management strategies

Chang-Patel

Palacios-Helgeson

Gould

2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewAdnexal torsion remains a diagnostic challenge heavily reliant on high clinical suspicion, with patient presentation and imaging used as adjuncts to aid in its diagnosis. This review summarizes diagnostic and management techniques of adnexal torsion to assist providers when encountering this surgical emergency. Recent findingsCommon findings of adnexal torsion include abdominal pain, nausea, vomiting, and adnexal mass or ovarian enlargement. An elevated neutrophil to lymphocyte ratio may be useful for diagnosis. A 'whirlpool' sign, 'follicular ring' sign, enlarged/edematous ovary, and absent Doppler flow to the ovary are highly suggestive of adnexal torsion. Intraoperative visual diagnosis of ovarian death is highly inaccurate, with only 18--20% of ovaries necrotic on pathological examination. Necrotic appearing ovaries have been shown to have follicular activity on ultrasound one year postoperatively.

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Oophoropexy to the Round Ligament after Recurrent Adnexal Torsion

Cited by 5 publications

References 9 publications

A New Technique of Oophoropexy: Folding and Fixating of Utero-Ovarian Ligament to Round Ligament in a Patient with Reccurrent Ovarian Torsion

A New Technique of Oophoropexy: Folding and Fixating of Utero-Ovarian Ligament to Round Ligament in a Patient with Reccurrent Ovarian Torsion

Ovarian Torsion in Polycystic Ovary Syndrome: A Potential Threat?

Adnexal torsion: a review of diagnosis and management strategies

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