Ovarian torsion following hysterectomy with salpingectomy: a retrospective case-control study

To determine whether hysterectomy, and hysterectomy with concurrent salpingectomy, are associated with subsequent ovarian torsion.

A retrospective single-centre case-control study was conducted, comprising women admitted to a gynaecological referral hospital with ovarian torsion (cases) between 1/6/2013 and 31/5/2020. A control group included women presenting with Bartholin's gland cyst/abscess during the same period.

103 cases and 371 controls were included; the groups were similar in age (p = 0.115). Cases were more likely to be pregnant (p < 0.001) and to have an ovarian cyst (p < 0.001). There were only 18 participants withprevioushysterectomy (13 cases, 5 controls). On univariate analysis, history of any hysterectomy was associated with increased odds of ovarian torsion (OR 9.94, 95% CI 3.59-27.51; p < 0.001). Hysterectomy with salpingectomy showed a similar association (OR 11.82, 95% CI 3.45-40.48; p < 0.001), and laparoscopic hysterectomy with salpingectomy had the highest observed odds (OR 13.15, 95% CI 3.15-54.86; p < 0.001). Isolated salpingectomy without hysterectomy was not associated with torsion (p = 0.458); hysterectomy without salpingectomy did not reach significance (p = 0.05).

Hysterectomy performed with concurrent salpingectomy may be associated with an increased odds of subsequent ovarian torsion. These findings warrant confirmation and investigation of preventive strategies in well-designed prospective studies with larger proportionsof participants with hysterectomy.