Oophoropexy to prevent adnexal torsion: how, when, and for whom?

Abstract

Study objective: To assess the efficacy of oophoropexy in obviating recurrent torsion and its possible long-term effects.

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

Setting: University hospital.

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

Measurements and main 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.

Conclusion: 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.