Oophoropexy for Prevention of Recurrent Torsion of Normal Adnexa

Abstract

<h3>Study Objective</h3> The conservative management of otherwise normal adnexal torsion by de-torsion may lead to recurrent torsion events. With the aim of reducing recurrent torsion events, various oophoropexy techniques have been suggested. We aimed to investigate the efficacy of oophoropexy in preventing recurrent torsion. <h3>Design</h3> Retrospective cohort study. <h3>Setting</h3> University affiliated department of Obstetrics and Gynecology. <h3>Patients or Participants</h3> Cases of oophoropexy operated between January 2010 and March 2021. <h3>Interventions</h3> Laparoscopic oophoropexy techniques (plication of the utero-ovarian ligament and/or fixation to the round ligament), using non-absorbable sutures. <h3>Measurements and Main Results</h3> 15 patients with recurrent torsion of otherwise normal adnexa who underwent oophoropexy were identified. At time of the first torsion event, the mean patients' age was 18.3 ± 7.4 years, and 4 (26.7%) were pre-menarchal. The recurrent torsion involved the right adnexa in 9 (60.0%) cases, the left adnexa in 4 (26.7%) cases, and both adnexa in 2 (13.3%) cases. The mean interval between the first and second torsion events was 17.8 ± 20.2 months. In 3 (20.0%) cases, no recurrence occurred following oophoropexy, while in the remaining 12 (80.0%) cases, up to 4 recurrences were diagnosed. <h3>Conclusion</h3> Laparoscopic oophoropexy procedures, although feasible and safe, may not prevent recurrent torsion of otherwise normal adnexa.