69. Retrospective review of outcomes after oophoropexy through the NASPAG Fellows Research Consortium

Abstract

<h3>Background</h3> Adnexal torsion is a rare pediatric event. Normal ovaries can torse and are more likely to re-torse, especially in premenarchal girls. Oophoropexy (OP) has been proposed to decrease the risk of recurrent torsion, yet there is no consensus to describe appropriate candidates or optimal surgical technique. Our study describes rates of recurrent adnexal torsion with and without OP. Using data from centers across the country, we aim to define if there are circumstances when OP may be beneficial. <h3>Methods</h3> This is an IRB-approved retrospective chart review of all patients aged 18 and under who experienced 2 or more ovarian torsions and/or underwent OP between 1 January 2009 and 30 August 2019. We determined the total number of patients who experienced torsion during the study period and collected data only for those meeting inclusion criteria using CPT, ICD9 and ICD10 codes. We recorded the number of surgically confirmed torsions, if OP was performed and surgical technique. Only data for the pilot site is included in this abstract. <h3>Results</h3> We identified 141 unique patients with at least one surgically-proven torsion and 171 torsion events. There were 44 patients who had at least 2 torsions and/or at least one OP. Mean age at first torsion was 10.6 years with a range of 2 to 18 years. The rate of recurrent torsion was 14.9% (21/141 patients) with 18 of 21 occurring in premenarchal girls. A total of 34 patients had at least one OP (mean age at first torsion 10 years, range 2-18 years). There were 6 patients who had a torsion after OP (17.6%). Of the 7 patients who had three or more torsions, 5 also had two or more OP. <h3>Conclusions</h3> The pilot site data for this ongoing multicenter cohort is the largest series to date. The overall rate of recurrent torsion, as well as the rate of torsion after OP, are comparable to existing literature. The majority of patients with recurrent torsion were premenarchal. All but two patients with three or more torsions also had two or more OP, and at least one torsion after OP. Although this is a limited sample, it suggests that some patients may retain the risk of recurrent torsion even after OP. Collecting data from additional sites will allow for further evaluation of these trends.