Is Ovarian Torsion Associated with Ligament Length?
BACKGROUND AND PURPOSE:
Yaniv et al. (Gynecologic and Obstetric Investigation, 2018) examined whether ovarian ligament length is associated with ovarian torsion
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
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
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.
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