BACKGROUND AND PURPOSE:

• Yaniv et al. (Gynecologic and Obstetric Investigation, 2018) examined whether ovarian ligament length is associated with ovarian torsion

METHODS:

• Prospective cohort study
• Women undergoing surgery for either
  • Ovarian torsion or
  • Other gynecologic condition
• The length of the ovarian ligaments were measured during laparoscopy using a disposable ruler
  • Ovary held without tension
  • Measurement performed after detorsion
  • Length measured from uterine origin to ovarian insertion

RESULTS:

• 28 in torsion group | 28 in non-torsion gyn group
• In control group, left and right ligaments were of equal size
• In the torsion group, ovarian torsions occurred mainly on the right side (67.9%)
• There was a significant correlation between ovarian ligament length and torsion
• In ovarian torsion group, ligament length on torsion side was longer than non-torsion side
  • 3.1 cm vs 2.3 cm (p=0.0018)
• Ligament of the torsion group was also longer vs ovarian ligament in the control group
  • 3.1 vs 2.2 cm (p=0.0005)
• The right ovarian ligament in the torsion group was longer than
  • The opposite side in the torsion group: 3.2 vs 2.0 cm (p<0.0001)
  • The right ovarian ligament in the control group: 3.2 vs 2.2 cm (p<0.0001)
• Presence of ovarian cyst
  • In the torsion group, there was no significant difference in ovarian ligament length with (3.3 cm) vs without (3.2 cm) an ovarian cyst

CONCLUSION:

• Increased length of ovarian ligament might be associated with increased risk of ovarian torsion
• This study cannot determine if the lengthening is a result or cause of the twisting
  • Authors postulate that since torsion is usually an acute event, lengthening is likely a cause not a result of torsion
• Since left and right ligaments were of equal size in the control group, increased right-sided frequency of torsion may be related to
  • sigmoid colon preventing left sided torsion
  • Some data showing dermoid cysts more likely to be right-sided
• The authors suggest

that increased ovarian ligament length might be correlated with the development of ovarian torsion. This can help the clinician with the decision of whether or not to shorten the ovarian ligament at the time of ovarian torsion surgery. However, further studies are needed to establish this connection.

Learn More – Primary Sources:

Correlation between the Length of Ovarian Ligament and Ovarian Torsion: A Prospective Study

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