Oophoropexy to prevent adnexal torsion recurrence in children

Abstract

Oophoropexy to prevent adnexal torsion recurrence in children Jian-Sheng Wei1, *, Min-Yan Zhang1 , Shen Liu1 , Kang Li1 , Jun-Jie Fu1 , Peng Lin1 1Department of Pediatric Urology, Fuzhou Children’s Hospital, 350001 Fuzhou, Fujian, China *Correspondence: fjetyylwfb@126.com (Jian-Sheng Wei) DOI:10.31083/j.ceog4805175 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 11 January 2021 Revised: 06 February 2021 Accepted: 02 March 2021 Published: 15 October 2021 Background: Adnexal torsion in Children is a rare event, and oophoropexy for the prevention of adnexal torsion in children is still controversial. The aim of this study was to analyze how retorsion can be prevented. Method: We performed a retrospective review of hospital charts of all patients aged 0–18 years with a diagnosis of adnexal torsion at the fuzhou Children's Hospital at Fujian province, from august 2014 to august 2019. Result: In total, 10 patients were included in the study. The average age of the patients was 5.5 years (range: 2 months–10 years). Clinical presentation: included pain (n = 9), vomiting (n = 3), and abdominal mass (n = 1). Surgical procedures included: laparoscopy (LP): cystectomy with detorsion (n = 5); cyst aspiration with detorsion (n = 1), and detorsion with oophoropexy (n = 2). One case underwent salpingooophorectomy LP (n = 1), which was converted to open laparotomhy Sapingo-oophorectomy. Recurrence occurred in two cases. Case 5 had recurrent adnexal torsion after oophoropexy with absorbable suture. The second episode was treated with oophoropexy with nonabsorbable suture and multiple points fixed. During the operation, the right ovarian ligament was longer, and hypermobile. Case 6 had recurrent cyst aspiration and the second episode was treated with cystectomy with oophoropexy. During the operation, the ovarian ligament was hypermobile. Follow-up: ultrasound showed normal ipsilateral adnexal, and no ovarian atrophy in eight patients. Conclusion: The recurrence of ovarian torsion in children may be caused by ovarian etiology and abnormal ovarian ligaments. Oophoropexy can prevent ovarian retorsion with non-absorbable sutures and multiple points fixed. Keywords Adnexal torsion; Children; Oophoropexy; Recurrence