Ovariopexy: Clinical and radiologic correlation

Abstract

Computerized tomography (CT) scans and sonograms of the pelvis were performed in 17 young female patients (13 postpubertal and 4 prepubertal), whose ovaries had been fixed either to the uterus or the pelvic wall to move them away from the field of radiation. These patients were given radiation therapy for the treatment of Hodgkin's disease (n = 15) or rhabdomyosarcoma (n = 2). The mean age of the postpubertal girls was 16.5 years (range 12–21) and the CT scans were done 2–7 years following radiation therapy. Ovarian function was determined based upon the patient reporting normal menstrual function and normal levels of follicle-stimulating hormone (FSH). FSH levels in the postpubertal girls were elevated in 5 patients and normal in 8. The ovaries could not be seen on CT scans of the 9 patients with elevated FSH and clinical signs of estrogen deficiency, while of the 8 patients with normal FSH levels, 7 had ovaries visualized by CT. Thus, visualization of the ovaries of adolescent girls correlated with the preservation of ovarian function in the majority of patients. Lack of detectable ovarian function correlated with lack of ability to visualize ovarian tissue on the sonograms or CT radiographs. Estrogen replacement is recommended to limit the consequences of therapy-induced ovarian failure.