Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (1): 62-64    DOI: 10.31083/j.ceog.2020.01.5017
Original Research Previous articles | Next articles
Adnexal torsion: is there a familial tendency?
N. Smorgick1, *(), O. Nir1, M. Pekar-Zlotin1, S. Maymon1, Y. Melcer1, R. Maymon1
1Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Affiliated with Sackler School of Medicine, Tel Aviv University, Israel
Download:  PDF(482KB)  ( 213 ) Full text   ( 6 )
Export:  BibTeX | EndNote (RIS)      
Abstract  

Objective: To investigate whether patients diagnosed with adnexal torsion report a family history of adnexal torsion in a first degree relative. Materials and Methods: All women with a surgical diagnosis of adnexal torsion operated from 2008 to 2016 were contacted for participation in the study. The study was conducted by a telephone questionnaire. In addition, the medical records were retrospectively reviewed and information on demographic characteristics, surgical findings at time of torsion, and history of recurrent torsion events were collected. Results: Two hundred thirty women with a surgical diagnosis of adnexal torsion were identified. Of these, 147 women were reached and agreed to participate in the study. A history of adnexal torsion in a first degree relative was reported by seven (4.8%) patients: three cases involved an adnexal torsion event in a sister, and four cases involved an adnexal torsion event in a mother or daughter. Patients with a positive family history of adnexal torsion were more likely to experience torsion of otherwise normal adnexa without adnexal cysts compared to those with a negative family history (71.4% vs. 27.1%, p = 0.01) and to report recurrent torsion events (57.1% vs. 17.1%, p = 0.009). Conclusion: A family history of adnexal torsion in a first degree relative is found in a minority of cases and is significantly associated with torsion of otherwise normal adnexa and with recurrent torsion events. Thus, patients with a family history of torsion may be considered a high-risk subgroup of patients.

Key words:  Adnexal torsion      Ovarian torsion      Recurrent torsion     
Published:  15 February 2020     
*Corresponding Author(s):  N. Smorgick     E-mail:  noam_yossi@yahoo.com

Cite this article: 

N. Smorgick, O. Nir, M. Pekar-Zlotin, S. Maymon, Y. Melcer, R. Maymon. Adnexal torsion: is there a familial tendency?. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 62-64.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.01.5017     OR     https://ceog.imrpress.com/EN/Y2020/V47/I1/62

Figure 1.  — The study’s flow chart.

Table 1  — Comparison of demographic and adnexal torsion characteristics between the entire torsion cohort and the study participants (study cohort).
Parameter Torsion cohort (n=230) Study cohort (n=147) p value
Age (years) 24.7 ± 11.2 24.5 ± 11.4 0.2
Menarchal status
Pre-menarchal 32 (13.9) 24 (16.3) 0.3
Post-menarchal 198 (86.1) 123 (83.7)
Age group
Girls and adolescents 81 (35.2) 49 (33.3)
0.8
Reproductive-age 95 (41.3) 65 (44.2)
Pregnancy 54 (23.5) 33 (22.4)
Torsion type
Torsion involving
normal adnexa
57 (24.8) 43 (29.3)

0.2
Torsion involving
adnexal cysts/mass
173 (75.2) 104 (70.7)
Recurrent torsion episodes 33 (14.3) 28 (19.0) 0.4
Table 2  — Description of patients with family history of adnexal torsion in a first degree relative.
# Age* Menarchal status** Adnexal pathology Recurrent torsion Familial history of torsion
1 6 Pre-menarchal Torsion involving normal adnexa Yes Sister
2 9 Pre-menarchal Dermoid cyst No Mother
3 13 Post-menarchal Corpus luteum cyst No Mother
4 22 Post-menarchal Torsion involving normal adnexa Yes Sister
5 22 Post-menarchal Torsion involving normal adnexa No Sister
6 23 Post-menarchal Torsion involving normal adnexa Yes Mother
7 32 Post-menarchal Torsion involving normal adnexa Yes Daughter
Table 3  — Comparison of demographic and adnexal torsion characteristics between patients with and without a family history of adnexal torsion.
Parameter Positive family history of adnexal torsion (n=7) Negative family history of adnexal torsion (n=140) p value
Age (years) 18.1 ± 9.2 24.8 ± 11.4 0.1
Menarchal status
Pre-menarchal 2 (28.6) 22 (15.7) 0.3
Post-menarchal 5 (71.4) 118 (84.3)
Age group
Girls and adolescents 3 (42.9) 46 (32.9)
0.3
Reproductive-age 4 (57.1) 61 (43.6)
Pregnancy 0 (0) 33 (23.6)
Torsion type
Torsion involving normal adnexa 5 (71.4) 38 (27.1) 0.01
Torsion involving adnexal cysts/mass 2 (28.6) 102 (72.9)
Recurrent torsion episodes 4 (57.1) 24 (17.1) 0.009
[1] Check J.H., Cohen G., Cohen R., Dipietro J., Steinberg B.: “Sympathomimetic amines effectively control pain for interstitial cystitis that had not responded to other therapies”. Clin. Exp. Obstet. Gynecol., 2013, 40, 227.
[2] Guthrie B.D., Adler M.D., Powell E.C.: “Incidence and trends of pediatric ovarian torsion hospitalizations in the United States, 20002006”. Pediatrics., 2010, 125, 532.
[3] Smorgick N., Melcer Y., Sarig-Meth T., Maymon R., Vaknin Z., Pansky M.: “High risk of recurrent torsion in premenarchal girls with torsion of normal adnexa”. Fertil. Steril., 2016, 105, 1561.
[4] Spinelli C., Piscioneri J., Strambi S.: “Adnexal torsion in adolescents: update and review of the literature”. Curr. Opin. Obstet. Gynecol., 2015, 27, 320.
[5] Crouch N.S., Gyampoh B., Cutner A.S., Creighton S.M.: “Ovarian torsion: to pex or not to pex? Case report and review of the literature”. J. Pediatr. Adolesc. Gynecol., 2003, 16, 381.
[6] Multani J., Kives S.: “Dermoid cysts in adolescents”. Curr. Opin. Obstet. Gynecol., 2015, 27, 315.
[7] Kiseli M., Caglar G.S., Cengiz S.D., Karadag D., Ylmaz M.B.: “Clinical diagnosis and complications of paratubal cysts: review of the literature and report of uncommon presentations”. Arch. Gynecol. Obstet., 2012, 285, 1563.
[8] Fuchs N., Smorgick N., Tovbin Y., Ben Ami I., Maymon R., Halperin R ., et al.: “Oophoropexy to prevent adnexal torsion: how, when, and for whom?”. J. Minim. Invasive. Gynecol., 2010, 17, 205.
[1] T.N. Yu, Y.L. Liu, Y.X. Lee, C.R. Tzeng, C.H. Chen. Vibration-related ovarian torsion in a patient undergoing in vitro fertilization: A case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 415-418.
[2] S.B. Cohen, R. Schonmann, J. Boaziz, D. S. Seidman, R. Orvieto, R. Mashiach. Inhibin B level changes during the follicular phase in rats with unilateral ovarian torsion[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 797-799.
[3] J. Jeong, J. Yang, Y. J. Song, Y. J. Na, H. G. Kim. A case report of acute ovarian cyst torsion by female adnexal tumor of probable Wölffian origin[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 824-827.
[4] Y.S. Kim, H.S. Han, J.H. Sang. Adnexal torsion in early pregnancy after assisted reproduction: can the adnexa be saved?[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(1): 135-137.
No Suggested Reading articles found!