Oophoropexy to prevent adnexal torsion: how, when, and for whom?
OBJECTIVE
To assess the efficacy of oophoropexy in obviating recurrent torsion and its possible long-term effects.


METHODS
Case series and review of the literature (Canadian Task Force classification III).


METHODS
University hospital.


METHODS
Women who underwent oophoropexy for recurrent torsion of normal adnexa between 2003 and 2008.


RESULTS
Retrieved information included the indication for oophoropexy, surgical methods, recurrence, and follow-up. Seven women underwent oophoropexy during the study period because of recurrent torsion of normal adnexa. One additional patient had experienced 3 torsion events of cystic adnexa. Surgical methods included suturing of the ovary to the pelvic sidewall or to the round ligament and plication of the utero-ovarian ligaments. Recurrence occurred in 1 of 6 patients for whom follow-up was available. All 6 patients reported spontaneous menstruation, and 2 conceived spontaneously and gave birth. Ultrasound at long-term follow-up (9-58 months) demonstrated normal ovaries.


CONCLUSIONS
Oophoropexy seems to be efficacious in preventing recurrent torsion. It is our impression that plication of the utero-ovarian ligaments has advantages over other approaches insofar as surgical feasibility and anatomical conservation.
Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel.
Noga
N
Fuchs
Noam
N
Smorgick
Yoseph
Y
Tovbin
Ido
I
Ben Ami
Ron
R
Maymon
Reuvit
R
Halperin
Moty
M
Pansky
D000291:Adnexal Diseases / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010053:Ovary / Q000601:surgery*; D018579:Patient Selection; D012189:Retrospective Studies; D055502:Secondary Prevention; D013536:Suture Techniques; D014102:Torsion Abnormality / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult