Repeated ovariopexy failure in recurrent adnexal torsion: combined approach and review of the literature

Şimşek, Erhan; Kılıçdağ, Esra Bulgan; Kalaycı, Hakan; Şimşek, Seda Yüksel; Parlakgümüş, Alper

doi:10.1016/j.ejogrb.2013.06.044

Cited by 18 publications

(22 citation statements)

References 27 publications

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“…Adnexal torsion involves the rotation of the ovary on its ligamentous supports often leading to interruption of its blood supply and in some cases necrosis. Adnexal torsion accounts for 2.5–5% of all gynaecological emergencies [ 5 ]. Adnexal torsion is rare but its frequency is increasing with the increasing use of fertility treatments which can cause ovarian hyperstimulation.…”

Section: Discussionmentioning

confidence: 99%

“…On review of the literature, plication of the uteroovarian ligament is the preferred technique of oophoropexy as it supposedly has minimal effect on fertility outcome. A combined approach of fixation of the ovary and shortening of the ligament may be more efficacious in preventing recurrence [ 5 ] (see Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…This patient subsequently underwent elective uteroovarian ligament shortening with no further episodes. This brings to light the issue of timing when performing oophoropexy due to the potential issue of suture instability in fragile, oedematous, and/or ischaemic tissue when oophoropexy is performed at the time of diagnosis of torsion [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…There have been some case reports linking torsion with polycystic ovarian syndrome due to increased ovarian volume [ 4 ]. Some experts advise that oophoropexy should be performed in cases of ovarian torsion in childhood to prevent recurrence particularly when one ovary has been removed [ 5 ]. However, there are doubts about the routine use of oophoropexy due to the lack of long-term follow-up studies in regard to its effect on future fertility.…”

Section: Introductionmentioning

confidence: 99%

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Oophoropexy for Recurrent Ovarian Torsion

Hartley¹,

Akhtar²,

Edi-Osagie³

2018

Case Reports in Obstetrics and Gynecology

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A 31-year-old nulliparous patient presents with a three-day history of right sided colicky abdominal pain and associated nausea. This patient has previously presented twice with right sided ovarian torsion with the background of polycystic ovaries in the last two consecutive years. Blood tests were normal. Due to previous history, there was a high index of clinical suspicion that this may be a further torsion. Therefore, the patient was taken to theatre for a diagnostic laparoscopy and a further right sided ovarian torsion was noted. At this time, oophoropexy was performed to the uterosacral ligament to prevent further torsion in order to preserve the patients' fertility. In this article, we detail this case and also provide a discussion of ovarian torsion including risk factors, presentation, and current thoughts on management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Oophoropexy for Recurrent Ovarian Torsion

Hartley¹,

Akhtar²,

Edi-Osagie³

2018

Case Reports in Obstetrics and Gynecology

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show abstract

“…Adnexal plication due to ipsilateral retorsion is recommended by several previous studies and is performed routinely in our department [17]. However, several concerns are raised by ovarian plication, including interfering with ovarian blood supply and function, chronic pain, and adhesion formation [18].…”

Section: Discussionmentioning

confidence: 99%

Correlation between the Length of Ovarian Ligament and Ovarian Torsion: A Prospective Study

Yaniv

Schonmann

Agizim

et al. 2018

Gynecol Obstet Invest

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Study Objective: The study aimed to evaluate whether there is an association between the ovarian ligament length and ovarian torsion. Design: This is a prospective cohort study. Design Classification: II.2. Setting: The study was conducted in the gynecology department of a university affiliated hospital. Intervention: We measured the length of the ovarian ligaments during laparoscopy. Patients: A total of 56 women were recruited, of which 28 women were operated for ovarian torsion (torsion group) and 28 others for other gynecologic conditions (control group). Measurement and Main Results: The study found correlations between ovarian ligament length and ovarian torsion. The length of the right (2.2 ± 0.6 cm) and left ovarian ligament (2.3 ± 0.8 cm) in the control patients were similar. Ovarian torsions occurred mainly on the right side (67.9 %). The right ovarian ligament was significantly longer in the torsion group (3.2 ± 0.9 cm) than in the control group (2.2 ± 0.6 cm; p < 0.001). Even after exclusion of patients with ovarian cyst, the ovarian ligament was still significantly longer in the torsion group as compared to the control group (3.2 ± 1.1 vs. 2.2 ± 0.6 cm respectively, p = 0.01). Conclusion: Our results suggest that increased length of ovarian ligament might be correlated with the development of ovarian torsion. This could be a basis for ovarian ligament fixation or oophoropexy at the time of conservative surgery for ovarian torsion.

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Ovarian torsion in the pediatric population: predictive factors for ovarian-sparing surgery—an international retrospective multicenter study and a systematic review

Spinelli

Tröbs

Nissen

et al. 2022

Arch Gynecol Obstet

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Study objective Ovarian torsion (OT) in pediatric age is a challenging condition to diagnose and treat. To date, there is still no clear consensus about its management. Our aim was to assess some possible associated factors that can help surgeons in decision-making. Design We conducted a retrospective multicentric study of pediatric OT surgically treated between 2010 and 2020 in six Italian and German institutions, comparing our findings with a literature review of the last 10 years (2010–2020). Participants Patients aged 0–18 years with a diagnosis of OT intraoperatively confirmed and surgically treated at the involved institutions. Results Ninety-seven patients with a mean age at diagnosis of 8.37 years were enrolled in the study. Severe abdominal pain was present in 82 patients (84.5%). Eighty children (82.5%) presented an enlarged ovary with an US diameter > 5 cm and only 32 (40%) of them underwent conservative surgery. A laparoscopic approach was performed in 60 cases (61.9%) although in 15 (15.5%) conversion to open surgery was deemed necessary. A functional cyst was present in 49 patients (50.5%) while 11 children (11.3%) suffered from OT on a normal ovary. Conclusions Our results showed that a post-menarchal age (p = .001), a pre-operative US ovarian size < 5 cm, (p = .001), the presence of severe abdominal pain (p = .002), a laparoscopic approach (p < .001), and the presence of a functional cyst (p = .002) were significantly associated with conservative surgery.

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Repeated ovariopexy failure in recurrent adnexal torsion: combined approach and review of the literature

Cited by 18 publications

References 27 publications

Oophoropexy for Recurrent Ovarian Torsion

Oophoropexy for Recurrent Ovarian Torsion

Correlation between the Length of Ovarian Ligament and Ovarian Torsion: A Prospective Study

Ovarian torsion in the pediatric population: predictive factors for ovarian-sparing surgery—an international retrospective multicenter study and a systematic review

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