Re-torsion of the ovaries
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Re-torsion of the ovaries. / Hyttel, Trine E W; Bak, Geske S; Larsen, Solveig B; Løkkegaard, Ellen C L.
In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 94, No. 3, 03.2015, p. 236-244.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Re-torsion of the ovaries
AU - Hyttel, Trine E W
AU - Bak, Geske S
AU - Larsen, Solveig B
AU - Løkkegaard, Ellen C L
N1 - © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.
PY - 2015/3
Y1 - 2015/3
N2 - 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.
AB - 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.
KW - Adnexal Diseases
KW - Adult
KW - Female
KW - Gynecologic Surgical Procedures
KW - Humans
KW - Ovarian Cysts
KW - Ovary
KW - Pregnancy
KW - Pregnancy Complications
KW - Risk Factors
KW - Torsion Abnormality
KW - Young Adult
U2 - 10.1111/aogs.12542
DO - 10.1111/aogs.12542
M3 - Review
C2 - 25412114
VL - 94
SP - 236
EP - 244
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 3
ER -
ID: 156085558