Objective:
To report on the surgical approach in cases of ovary torsion that develop after preventive surgery and on the effects of the attacks on the ovary reserve
Design:
The presentation of the case.
Setting:
University Hospital.
The patient:
The sixteen-year-old girl, who had lost her right adnexa because of torsion, suffered successive torsion in the left adnexa after preventive surgery.
Intervention:
Through the laparoscopic method, the utero-ovarian ligament was shortened and ovariopexy was applied to the back of the uterus. The ovarian reserve between the attacks was monitored.
Main Outcome Measure:
The prevention of recurring torsions through the surgical method and thereby the preservation of the ovarian reserve.
Result:
The ovary must be protected under all circumstances during the treatment of torsion. More than one method of adnexa fixation may prove necessary to prevent further attacks.
Conclusion:
The case we present here is the only one in which the two sides were successively affected, despite the surgical intervention to prevent any recurrence, and also the only one in which the ovarian reserve between the attacks was monitored. Apparently, the ovarian reserve is affected badly by recurrent torsion attacks, though the reserve tests indicate some improvement in the months following the last attack.
Keywords: Recurrent ovarian torsion, ovarian reserve, anti-müllerian hormone, oophoropexy, ovariopexy, laparoscopy