Recurrent Ovarian Torsion: Risk Factors and Predictors for Outcome of Oophoropexy

Study Objective: To identify risk factors for recurrent ovarian torsion and evaluation of the efficacy of oophoropexy techniques. Design: Case control study. Setting: Tertiary university-affiliated medical center. Patients: A total of 79 women with recurrent ovarian torsion (study group) were matched with 158 women with a single episode of ovarian torsion (control group). Interventions: Laparoscopic detorsion and oophoropexy. Measurements and Main Results: Demographic data, clinical characteristics, ultrasound characteristics, surgical findings, surgical procedures, and torsion recurrence rates were analyzed and compared between the 2 groups between 2001 to 2020. Results: There was an inverse association between women's age and the risk of recurrent torsion (adjusted odds ratio [aOR], 0.89; 95% confidence interval [CI], 0.83-0.96, p =.003). Moreover, in women younger than 20 years, the risk of recurrent event was substantially higher (aOR, 5.0; 95% CI, 1.56-6.15, p =.007). In addition, the absence of ovarian pathology was associated with increased risk for recurrent torsion (aOR, 14.3; 95% CI, 6.15-33.42; p <.001). Oophoropexy was performed in 46 women in the study group. The risk of recurrent torsion after oophoropexy was 30%. A long duration of pain before admission was associated with oophoropexy failure (37.5 +/- 6.3 hours vs 11.7 +/- 6.0 hours, p =.003). No single fixation procedure was superior to the others in terms of therapeutic success. Conclusion: Recurrent ovarian torsion is more common in young women with a normal-appearing ovary. Oophoropexy is a safe procedure with a risk of retorsion in 30% of the patients. We found no advantage for one fixation technique over the others. Journal of Minimally Invasive Gynecology (2022) 29, 1011- 1018. (c) 2022 AAGL. All rights reserved.