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Oophoropexy to prevent adnexal torsion: how, when, and for whom?
Noga Fuchs1, Noam Smorgick, Yoseph Tovbin
1Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel.
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.
