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Ovarian Preservation and Recurrent Torsion in Children: Both Less Common Than We Thought

Rebecca A Saberi1, Gareth P Gilna1, Cindy Rodriguez2

  • 1DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida.

The Journal of Surgical Research
|November 29, 2021
PubMed

Insights

In pediatric ovarian torsion cases, half of patients undergo total oophorectomy (TO), with ovarian preservation surgery (OPS) disparities noted. Both surgical methods show similar readmission and recurrent torsion rates.

Area of Science:

  • Pediatric Surgery
  • Gynecologic Oncology
  • Reproductive Health

Background:

  • Pediatric ovarian torsion management involves total oophorectomy (TO) or ovarian preservation surgery (OPS).
  • Understanding factors influencing surgical choice and readmission outcomes is crucial for optimizing patient care.
  • Previous data on surgical management disparities and outcomes for pediatric ovarian torsion is limited.

Purpose of the Study:

  • To identify factors associated with the surgical management of pediatric ovarian torsion (TO vs. OPS).
  • To compare readmission rates and outcomes between TO and OPS in pediatric patients.
  • To analyze disparities in the utilization of ovarian preservation surgery.

Main Methods:

  • Utilized the Nationwide Readmission Database (2010-2014) to identify pediatric patients (<18 years) with ovarian torsion.
  • Compared patient demographics, hospital characteristics, and readmission outcomes between TO and OPS groups.
  • Employed weighted statistical analysis to derive national estimates.

Main Results:

  • Of 6028 patients, 50% underwent TO and 50% underwent OPS.
  • OPS was more frequent in teaching hospitals, younger patients (<13 years), and those from high-income households.
  • Overall readmission rates were similar (4.3% OPS vs. 4.4% TO), as were recurrent torsion rates (<0.3% OPS vs. <0.2% TO).

Conclusions:

  • Approximately half of pediatric ovarian torsion cases in the U.S. involve total oophorectomy, with observed disparities in OPS utilization.
  • No significant difference exists in readmission or recurrent torsion rates between TO and OPS.
  • The overall rate of recurrent torsion is lower than previously reported in the literature.
Abstract

Keywords:
DetorsionOvarian preservationOvarian torsionPediatricReadmissionsRecurrent torsionRetorsion

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