Study determines factors associated with oophorectomy in patients with ovarian torsion
Ovarian torsion can cause severe pain and other symptoms because the ovary is not receiving enough blood due to twisting of its blood supply. It can occur at any age and is responsible for nearly three percent of all gynecologic emergencies. An oophorectomy is performed when there is concern that the torsed ovary is nonviable (necrosis) based on its dusky color. However, numerous studies have shown that a surgeon's ability to determine necrosis based on physical appearance is inaccurate.
To determine the factors associated with an increased likelihood for ovary removal during the time of surgery for ovarian torsion, researchers from Boston University School of Medicine (BUSM), conducted a retrospective study of patients from a racially diverse, urban safety-net hospital with a diagnosis of ovarian torsion during a four-and-a-half-year period.
Older age, having had more children in the past, larger ovarian size on imaging, having a laparotomy (large surgical incision into the abdominal cavity) and having a gynecologic oncologist perform the surgery were significantly associated with a higher likelihood of oophorectomy in ovarian torsion cases. In contrast to prior studies on oophorectomy, patient race did not impact the likelihood of oophorectomy in this study.
According to the researchers, only 20 percent of the ovaries removed were actually necrotic, consistent with other studies that found that ovarian function could be preserved in 88 to 100 percent of ovarian torsion cases, and none contained cancer.