Adnexal torsion recurrence-is the adnexal twist degree a risk factor? A retrospective cohort study

Objective To evaluate whether the adnexal twist degree is related to torsion recurrence and whether there is a dose-dependent correlation. Design A retrospective cohort study. Setting Single tertiary medical centre. Population The study includes non-pregnant patients operated, for the first time, for adnexal torsion, between 2011 and 2018. Methods Information regarding the degree of adnexal twist was collected from surgical reports. Recurrence was identified using a computerised database and ascertained via telephone with a response rate of 87.2% (253/290). Main outcome measures Adnexal torsion recurrence rate. Results A total of 182 women who had undergone laparoscopic detorsion met the inclusion criteria. Twenty-two had torsion recurrence (12.1%). Adnexal twist degree in the primary event was associated with a higher recurrence risk: 4.3% of women with twist degree <= 360 (n = 3/70), 14.5% of women with twist degree of 361-720 (n = 9/62) and 20% of women with twist degree >720 (n = 10/50) (P = 0.03). The median twist degree was 540 (interquartile range [IQR] 360-855) and 720 (IQR 675-1080) degrees in the control and study groups, respectively (P = 0.005). Additional possibly associated factors for recurrence were evaluated. Age emerged as a possible risk factor, with a median age of 19 years in the recurrence group (IQR 14-27 years) versus 28.5 (IQR 19-36 years) in the non-recurrence group (P < 0.01). Logistic regression analysis revealed that together with age, adnexal twist degree remained significantly associated with torsion recurrence (odds ratio [OR] 1.98, 95% CI 1.09-3.61; P = 0.02). Conclusion Adnexal twist degree was found to be positively associated with the risk of torsion recurrence. Tweetable abstract Adnexal twist degree was found to be positively associated with the risk of torsion recurrence.