title: Factors Affecting Adnexal Torsion Direction: A Retrospective Cohort Study.
abstract: OBJECTIVE
  To investigate a trend for adnexal torsion direction and factors that may be associated with direction.
  
  
  METHODS
  We retrospectively reviewed the medical files of all women who underwent exploratory laparoscopy for suspected ovarian torsion in our center from August 2010 to December 2012.
  
  
  RESULTS
  Fifty-five women had laparoscopically proven torsion. Medial rotation, defined as clockwise rotation of the left adnexa or counterclockwise rotation of the right adnexa, with the proximal (lateral) segment of the infundibulopelvic ligament serving as the referral point was noted in most cases (n = 47, 85.5%). There was no statistically significant difference between the medial and lateral rotation groups. However, the proportion of pregnant women and mean parity were significantly higher in the lateral compared to the medial rotation group: 62.5 vs. 19.1%, p = 0.009 and 1.1 ± 1.2 vs. 0.1 ± 0.4, p < 0.001. Medial torsion was present in 64.3% of pregnant women vs. 92.7% of nonpregnant women, p = 0.009.
  
  
  CONCLUSIONS
  The direction of ovarian or adnexal torsion is usually medially rotated, opposite to the psoas muscles and the great blood vessels on the same side. However, surgeons should be aware of an increased rate of lateral rotation among pregnant women.
authors.affiliation: Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Krissi
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
authors.forename: Chen
authors.initials: C
authors.lastname: Goldschmit
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000503:physiopathology / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D012399:Rotation; D014102:Torsion Abnormality / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult