Risk Factors for Strangulated Ovarian Hernia in Female Infants: the Role of Ovarian Volume.

The risk factors associated with strangulated ovarian hernia (SOH) in female patients (<1 year old) were identified. A retrospective analysis was conducted regarding the data from 2006 to 2017. The patients were divided into 2 groups: SOH group (n=9) and non-SOH group (n=23). Patient demographics, clinical signs, preoperative examinations and intraoperative findings were compared between the two groups, and risk factors for SOH were tested using a binary logistic regression model. To explore whether greater ovary was more likely to be twisted, leading to SOH, all the patients were divided into ovary volume <5 cm3 and ≥5 cm3 groups and the association between ovarian volume and ovary torsion was assessed. Among a total of 32 female patients (<1 year old) with incarcerated ovarian herniation, 9 patients developed SOH. The single variate analysis revealed that times of manual reduction, ovarian volume, ovary with or without multiple cysts, ovary torsion or not and angle of ovary torsion were found to be significant factors associated with SOH. The multivariate analysis showed ovarian volume was evidenced as an independent risk factor for SOH. Furthermore, the incidence of ovary torsion was significantly higher in ovarian volume ≥5 cm3 group than in ovarian volume <5 cm3 group, indicating that larger ovary was more likely to result in ovary torsion, leading to SOH. Our study demonstrated that the odds of SOH increased with increasing ovarian volume in female patients (<1 year old) because the relatively greater ovary at this age was more likely to be incarcerated and twisted, leading to SOH.