Abstract
The increasing use of de-torsion of the ovaries may result in re-torsion. This review addresses risk of re-torsion and describes preventive strategies to avoid re-torsion in pre-menarcheal girls, and fertile and pregnant women. We clinically reviewed PubMed, Embase, Trip and Cochrane databases. The main outcome measures were re-torsion and viability of ovary with fixation measures. A total of 38 publications including 71 girls, 363 fertile women, and 69 pregnant women were found to be relevant. All studies were case reports or case series, sometimes with non-randomized controls. The studies show considerable heterogeneity in design, population, management and outcome. Only four studies included more than 50 cases. In pregnancy the risk of re-torsion was as high as 19.5-37.5%; among fertile women it was 28.6%. Most articles concluded that fixation of the ovaries to the pelvic sidewall or plication of the ovarian ligament after torsion may prevent re-torsion. In one case a girl experienced re-torsion after ovariopexy. Based on observational studies it seems that de-torsion and fixation of the ovary is a safe procedure that usually ensures maintenance of ovarian function and reduces the risk of recurrence, especially when there are no ovarian cysts or adnexal masses.
| Original language | English |
|---|---|
| Journal | Acta Obstetricia et Gynecologica Scandinavica |
| Volume | 94 |
| Issue number | 3 |
| Pages (from-to) | 236-244 |
| Number of pages | 9 |
| ISSN | 0001-6349 |
| DOIs | |
| Publication status | Published - 1 Mar 2015 |
Keywords
- Adnexal Diseases
- Adult
- Female
- Gynecologic Surgical Procedures
- Humans
- Ovarian Cysts
- Ovary
- Pregnancy
- Pregnancy Complications
- Risk Factors
- Torsion Abnormality
- Young Adult