Margot Ollivier1, Sami Sfar Mohamed1, Benoit Tessier1, Yosra Ben Ahmed1, Amandine Coffy2, Sarah Garnier1, Marie Pierre Guibal1, Charles Sultan3, Francoise Paris3, Nicolas Kalfa4. 1. Department of Pediatric Surgery and Urology, Lapeyronie Hospital, University Hospital of Montpellier and University of Montpellier, Montpellier, France. 2. University Institute of Clinical Research, University of Montpellier, France. 3. Department of Pediatric Endocrinology, Arnaud de Villeneuve Hospital, University Hospital of Montpellier, Montpellier, France; Rare Disease National Reference Center (Constitutive South) DEVGEN. 4. Department of Pediatric Surgery and Urology, Lapeyronie Hospital, University Hospital of Montpellier and University of Montpellier, Montpellier, France; Rare Disease National Reference Center (Constitutive South) DEVGEN. Electronic address: nicolaskalfa@gmail.com.
Abstract
INTRODUCTION: To evaluate if torsion of an otherwise healthy ovary (THO) has a different prognosis than torsion with an underlying ovarian mass (TUOM) in children. MATERIAL AND METHODS: Children with an ovarian torsion who were treated in our department from 1997 to 2016 were studied retrospectively. Patients with prenatal ovarian torsion and isolated oviduct torsion were excluded. Trophicity of the ovary was assessed by ultrasonography at the end of follow-up. RESULTS: Fifty-four girls were included. Twenty-seven presented a TUOM; the others had a THO. Beside the deleterious effect of late surgical management, another prognostic factor was identified. THO was more prone to an ovarian hypotrophy or atrophy than TUOM (n = 20 vs n = 5, p < 0.01). This was confirmed by logistic regression analysis (OR = 5.08, p = 0.01). To explain this finding, we further compared TUOM and THO. The diagnosis of TUOM was more frequently suspected on US at the first visit (p = 0.005). TUOM also occurred more often after puberty (>12 years, 52.9% vs 11.1%, p < 0.001) than THO. CONCLUSION: THO is more frequently associated with an ovarian atrophy or hypotrophy than TUOM. A less obvious diagnosis at US and the early occurrence of THO before puberty with a less favorable hormonal climate may explain this finding. LEVEL OF EVIDENCE: III.
INTRODUCTION: To evaluate if torsion of an otherwise healthy ovary (THO) has a different prognosis than torsion with an underlying ovarian mass (TUOM) in children. MATERIAL AND METHODS:Children with an ovarian torsion who were treated in our department from 1997 to 2016 were studied retrospectively. Patients with prenatal ovarian torsion and isolated oviduct torsion were excluded. Trophicity of the ovary was assessed by ultrasonography at the end of follow-up. RESULTS: Fifty-four girls were included. Twenty-seven presented a TUOM; the others had a THO. Beside the deleterious effect of late surgical management, another prognostic factor was identified. THO was more prone to an ovarian hypotrophy or atrophy than TUOM (n = 20 vs n = 5, p < 0.01). This was confirmed by logistic regression analysis (OR = 5.08, p = 0.01). To explain this finding, we further compared TUOM and THO. The diagnosis of TUOM was more frequently suspected on US at the first visit (p = 0.005). TUOM also occurred more often after puberty (>12 years, 52.9% vs 11.1%, p < 0.001) than THO. CONCLUSION: THO is more frequently associated with an ovarian atrophy or hypotrophy than TUOM. A less obvious diagnosis at US and the early occurrence of THO before puberty with a less favorable hormonal climate may explain this finding. LEVEL OF EVIDENCE: III.
Authors: Alexandra Tielli; Andrea Scala; Marianne Alison; Van Dai Vo Chieu; Nicholas Farkas; Luigi Titomanlio; Léa Lenglart Journal: Eur J Pediatr Date: 2022-01-30 Impact factor: 3.183