Recurrent Torsion of Otherwise Normal Adnexa: Oophoropexy Does Not Prevent Recurrence

Abstract Purpose Recurrence of adnexal torsion involving otherwise normal adnexa is not rare. Various oophoropexy (ovarian fixation) procedures have been suggested to prevent recurrence, however, long-term information of their efficacy is lacking. The aim of this study was to investigate the recurrence rate of adnexal torsion following oophoropexy. Methods Retrospective cohort study, including all consecutive patients who underwent an oophoropexy procedure for the prevention of recurrent torsion of “normal adnexa” in our department from 2008 to 2021. Oophoropexy techniques included shortening of the utero-ovarian ligament (between 2008 to 2019) or combined utero-ovarian and round ligament fixation (from 2020). Results Twenty-one patients (age range 7-35 years) with a mean follow-up of 82.7 ± 60.6 months were identified. Fifteen of them (71.4%) were re-operated for recurrent torsion following an oophoropexy procedure, while six (28.6%) did not experience recurrence. Twelve (57.1%) torsion recurrences following an oophoropexy occurred within the first 2 postoperative years. There were no differences in mean age and menarchal status )pre- or post-menarchal) at the time of the first torsion event, age at the time of oophoropexy, oophoropexy side, number of adnexal torsion events before oophoropexy, and follow-up duration between those with and those without post-oophoropexy recurrences. Conclusion Oophoropexy procedures may not prevent recurrent torsion of otherwise normal adnexa. Further studies to determine whether combined fixation (utero-ovarian plication and round ligament) is more efficacious than isolated utero-ovarian plication for the prevention of recurrent torsion are warranted.