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  • Title: Recurrent Ovarian Torsion: Risk Factors and Predictors for Outcome of Oophoropexy.
    Author: Akdam A, Bor N, Fouks Y, Ram M, Laskov I, Levin I, Cohen A.
    Journal: J Minim Invasive Gynecol; 2022 Aug; 29(8):1011-1018. PubMed ID: 35577246.
    Abstract:
    STUDY OBJECTIVE: To identify risk factors for recurrent ovarian torsion and evaluation of the efficacy of oophoropexy techniques. DESIGN: Case control study. SETTING: Tertiary university-affiliated medical center. PATIENTS: A total of 79 women with recurrent ovarian torsion (study group) were matched with 158 women with a single episode of ovarian torsion (control group). INTERVENTIONS: Laparoscopic detorsion and oophoropexy. MEASUREMENTS AND MAIN RESULTS: Demographic data, clinical characteristics, ultrasound characteristics, surgical findings, surgical procedures, and torsion recurrence rates were analyzed and compared between the 2 groups between 2001 to 2020. RESULTS: There was an inverse association between women's age and the risk of recurrent torsion (adjusted odds ratio [aOR], 0.89; 95% confidence interval [CI], 0.83-0.96, p = .003). Moreover, in women younger than 20 years, the risk of recurrent event was substantially higher (aOR, 5.0; 95% CI, 1.56-6.15, p = .007). In addition, the absence of ovarian pathology was associated with increased risk for recurrent torsion (aOR, 14.3; 95% CI, 6.15-33.42; p <.001). Oophoropexy was performed in 46 women in the study group. The risk of recurrent torsion after oophoropexy was 30%. A long duration of pain before admission was associated with oophoropexy failure (37.5 ± 6.3 hours vs 11.7 ± 6.0 hours, p = .003). No single fixation procedure was superior to the others in terms of therapeutic success. CONCLUSION: Recurrent ovarian torsion is more common in young women with a normal-appearing ovary. Oophoropexy is a safe procedure with a risk of retorsion in 30% of the patients. We found no advantage for one fixation technique over the others.
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