Oophoropexy to Prevent Adnexal Torsion: How, When, and for Whom?

Study ObjectiveTo assess the efficacy of oophoropexy in obviating recurrent torsion and its possible long-term effects.DesignCase series and review of the literature (Canadian Task Force classification III).SettingUniversity hospital.PatientsWomen who underwent oophoropexy for recurrent torsion of normal adnexa between 2003 and 2008.Measurements and Main ResultsRetrieved information included the indication for oophoropexy, surgical methods, recurrence, and follow-up. Seven women underwent oophoropexy during the study period because of recurrent torsion of normal adnexa. One additional patient had experienced 3 torsion events of cystic adnexa. Surgical methods included suturing of the ovary to the pelvic sidewall or to the round ligament and plication of the utero-ovarian ligaments. Recurrence occurred in 1 of 6 patients for whom follow-up was available. All 6 patients reported spontaneous menstruation, and 2 conceived spontaneously and gave birth. Ultrasound at long-term follow-up (9–58 months) demonstrated normal ovaries.ConclusionOophoropexy seems to be efficacious in preventing recurrent torsion. It is our impression that plication of the utero-ovarian ligaments has advantages over other approaches insofar as surgical feasibility and anatomical conservation.