Re‐torsion of the ovaries

Hyttel, Trine E. W.; Bak, Geske S.; Larsen, Solveig Brixen; Løkkegaard, Ellen

doi:10.1111/aogs.12542

Cited by 27 publications

(23 citation statements)

References 36 publications

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“…To date, information related to recurrent AT is very limited. The literature reports an 8.7 to 28.6% incidence of recurrent AT, similar to our findings (16.5%) . Most of these studies were limited to small cohorts and case reports and characterized by special populations .…”

Section: Discussionsupporting

confidence: 90%

Ovarian size as a risk factor for recurrent adnexal torsion: Smaller is not better

Daykan

Bogin

Sharvit

et al. 2020

J of Obstet and Gynaecol

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Aim: To investigate characteristics and risk factors for recurrent adnexal torsion (AT). Methods: Retrospective cohort study in a university-affiliated medical center included 320 Women with AT verified by laparoscopy, from January 2005 through January 2017. Demographic data, clinical symptoms, surgical findings and treatment were retrospectively reviewed from patient records. Data from primary and secondary AT of patients in the recurrent torsion group was compared to those with single torsion, to evaluate risk factors for recurrent AT. Results: Two hundred and sixty seven (83.4%) patients had a single event of AT and 53 (16.5%) had recurrent AT. Patients with recurrent torsion had significantly fewer previous non-gynecologic surgeries (4.3% and 9.8% of the study groups vs 32.2% of the control group, P = 0.001 for both). Ovarian size was significantly smaller in the recurrent torsion groups (47.5 mm and 48.3 mm vs 63.9 mm, P = 0.045 and P = 0.012, respectively). Polycystic ovary was significantly more common in the recurrent AT group (P = 0.028 and P = 0.005), with risk ratio 4.4 (95% confidence interval, 1.66 to 11.63). Ovaries without any specific findings were also more common among recurrent AT cases (P = 0.001 for both groups). Logistic regression analysis demonstrated that smaller ovarian size is an independent risk factor for recurrent AT. Conclusion: Recurrent torsion correlated with fewer previous surgeries, small ovarian mass, polycystic ovaries and ovaries without specific findings, which might indicate that additional pathophysiological factors contribute to the recurrent event. Ovarian fixation might be recommended in patients with primary torsion of normal or polycystic ovaries.

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Section: Discussionsupporting

confidence: 90%

Ovarian size as a risk factor for recurrent adnexal torsion: Smaller is not better

Daykan

Bogin

Sharvit

et al. 2020

J of Obstet and Gynaecol

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“…Conservative surgery was defined as ovarian detorsion with or without ovarian cystectomy, ovarian cyst drainage or oophoropexy (Appendix S1). During the study period of January 2001 to September 2015, these codes remained the same and are detailed in Appendix S1. Obesity was defined by the ICD‐9 coding as body mass index of 30 kg/m 2 or greater.…”

Section: Methodsmentioning

confidence: 99%

Conservative surgery for ovarian torsion in young women: perioperative complications and national trends

Mandelbaum

Smith

Violette

et al. 2020

BJOG

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Objective To analyse populational trends and perioperative complications following conservative surgery versus oophorectomy in women <50 years of age with ovarian torsion. Design Population‐based retrospective observational study. Setting Nationwide Inpatient Sample in the USA (2001–2015). Population In all, 89 177 ovarian torsions including 20 597 (23.1%) conservative surgeries and 68 580 (76.9%) oophorectomies. Methods (1) Trend analysis to assess utilisation of conservative surgery over time, (2) multivariable binary logistic regression to identify independent factors associated with conservative surgery and (3) inverse probability of treatment weighting with a generalised estimating equation to analyze perioperative complications. Main outcome measures Trends, characteristics and complications related to conservative surgery. Results Performance of conservative surgery increased from 18.9 to 25.1% between 2001 and 2015 (32.8% relative increase, P = 0.001) but decreased steadily after age 15, and sharply declined after age 35 (P < 0.001). On multivariable analysis, younger age exhibited the largest effect size for conservative surgery among the independent factors (adjusted odds ratios 3.39–7.96, P < 0.001). In the weighted model, conservative surgery was associated with an approximately 30% decreased risk of perioperative complications overall (10.0% versus 13.6%, odds ratio 0.73, 95% confidence interval 0.62–0.85, P < 0.001) and was not associated with venous thromboembolism (0.2 versus 0.3%, P = 0.457) or sepsis (0.4 versus 0.3%, P = 0.638). Conclusion There has been an increasing utilisation of conservative surgery for ovarian torsion in the USA in recent years. Our study suggests that conservative surgery for ovarian torsion may not be associated with increased perioperative complications. Tweetable abstract Conservative surgery for ovarian torsion may not be associated with increased perioperative complications.

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“…Conservative surgery was defined as ovarian detorsion with or without ovarian cystectomy, ovarian cyst drainage or oophoropexy (Appendix S1). 22,23 During the study period of January 2001 to September 2015, these codes remained the same and are detailed in Appendix S1. Obesity was defined by the ICD-9 coding as body mass index of 30 kg/m 2 or greater.…”

Section: Study Definitionmentioning

confidence: 99%

Conservative surgery for ovarian torsion in young women: perioperative complications and national trends

Mandelbaum

Smith

Roman

et al. 2019

Fertility and Sterility

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Objective To analyse populational trends and perioperative complications following conservative surgery versus oophorectomy in women <50 years of age with ovarian torsion.Design Population-based retrospective observational study.Setting Nationwide Inpatient Sample in the USA (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015).Population In all, 89 177 ovarian torsions including 20 597 (23.1%) conservative surgeries and 68 580 (76.9%) oophorectomies.Methods (1) Trend analysis to assess utilisation of conservative surgery over time, (2) multivariable binary logistic regression to identify independent factors associated with conservative surgery and (3) inverse probability of treatment weighting with a generalised estimating equation to analyze perioperative complications.Main outcome measures Trends, characteristics and complications related to conservative surgery.Results Performance of conservative surgery increased from 18.9 to 25.1% between 2001 and 2015 (32.8% relative increase, P = 0.001) but decreased steadily after age 15, and sharply declined after age 35 (P < 0.001). On multivariable analysis, younger age exhibited the largest effect size for conservative surgery among the independent factors (adjusted odds ratios 3.39-7.96, P < 0.001). In the weighted model, conservative surgery was associated with an approximately 30% decreased risk of perioperative complications overall (10.0% versus 13.6%, odds ratio 0.73, 95% confidence interval 0.62-0.85, P < 0.001) and was not associated with venous thromboembolism (0.2 versus 0.3%, P = 0.457) or sepsis (0.4 versus 0.3%, P = 0.638).Conclusion There has been an increasing utilisation of conservative surgery for ovarian torsion in the USA in recent years. Our study suggests that conservative surgery for ovarian torsion may not be associated with increased perioperative complications.Tweetable abstract Conservative surgery for ovarian torsion may not be associated with increased perioperative complications.

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Re‐torsion of the ovaries

Cited by 27 publications

References 36 publications

Ovarian size as a risk factor for recurrent adnexal torsion: Smaller is not better

Ovarian size as a risk factor for recurrent adnexal torsion: Smaller is not better

Conservative surgery for ovarian torsion in young women: perioperative complications and national trends

Conservative surgery for ovarian torsion in young women: perioperative complications and national trends

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