Preoperative Clinical Features of Isolated Fallopian tube Torsion: Evidence from a Large Series

Abstract

Study Objective To study isolated fallopian torsion (IFTT) in a large cohort of women and to evaluate different features of IFTT in comparison to a large cohort of women with non-IFTT adnexal torsion (NIAT). Design A retrospective cohort study. Setting A tertiary, university affiliated medical center. Patients or Participants We included women with surgically confirmed ovarian and/or fallopian tube torsion between March 2011 and June 2020. We compared women with IFTT to those with NIAT during the same period. Interventions Diagnostic and operative laparoscopy. Measurements and Main Results Fifty-four cases of IFTT were surgically confirmed during the study period and were compared to 422 surgically confirmed NIAT. The rate of controlled ovarian hyperstimulation treatments, current pregnancy, and vomiting was lower in the IFTT group compared with the NIAT group. Cervical tenderness and vaginal discharge were more common in the IFTT group. Edematous and enlarged ovaries were less common in the IFTT group. In a multivariate regression analysis, the following factors were independently positively associated with IFTT; vaginal discharge [adjusted Odds Ratio (aOR) 95% CI 8.16, 1.98-33.55], and cervical motion tenderness (aOR 95% CI 2.71, 1.01-7.29). The following factors were independently negatively associated with IFTT; fertility treatments (aOR 95% CI 0.26, 0.70-0.77), previous abdominal surgery (aOR 95% CI 0.46, 0.22-0.96), vomiting (aOR 95% CI 0.38, 0.19-0.76) and enlarged ovary (aOR 95% CI 0.34, 0.18-0.65). Conclusion We have identified preoperative factors positively and negatively associated with IFTT in a large cohort of women with adnexal torsion. To study isolated fallopian torsion (IFTT) in a large cohort of women and to evaluate different features of IFTT in comparison to a large cohort of women with non-IFTT adnexal torsion (NIAT). A retrospective cohort study. A tertiary, university affiliated medical center. We included women with surgically confirmed ovarian and/or fallopian tube torsion between March 2011 and June 2020. We compared women with IFTT to those with NIAT during the same period. Diagnostic and operative laparoscopy. Fifty-four cases of IFTT were surgically confirmed during the study period and were compared to 422 surgically confirmed NIAT. The rate of controlled ovarian hyperstimulation treatments, current pregnancy, and vomiting was lower in the IFTT group compared with the NIAT group. Cervical tenderness and vaginal discharge were more common in the IFTT group. Edematous and enlarged ovaries were less common in the IFTT group. In a multivariate regression analysis, the following factors were independently positively associated with IFTT; vaginal discharge [adjusted Odds Ratio (aOR) 95% CI 8.16, 1.98-33.55], and cervical motion tenderness (aOR 95% CI 2.71, 1.01-7.29). The following factors were independently negatively associated with IFTT; fertility treatments (aOR 95% CI 0.26, 0.70-0.77), previous abdominal surgery (aOR 95% CI 0.46, 0.22-0.96), vomiting (aOR 95% CI 0.38, 0.19-0.76) and enlarged ovary (aOR 95% CI 0.34, 0.18-0.65). We have identified preoperative factors positively and negatively associated with IFTT in a large cohort of women with adnexal torsion.