Background: Recurrent ipsilateral ovarian torsion is uncommon; extreme recurrence (≥7 episodes) is exceptionally rare. Herniation of the adnexa through a broad ligament fenestration may precipitate torsion but is seldom reported. Optimal prevention of recurrence remains debated. Case: A 27-year-old woman with two prior vaginal births presented with acute right-lower-quadrant pain. Ultrasound showed an enlarged right ovary with absent color Doppler flow. She had seven prior right-sided torsions (2020–2024) managed surgically. Laparoscopy revealed a broad ligament fenestration on the right; the ovary had passed through this fenestration twice and undergone two 360° rotations on its axis. The ovary was delivered back through the window (reduction), detorsed, and oophoropexy was performed to the posterolateral uterine serosa; the broad ligament defect was closed. Pain resolved. At the 1-week and 3-month follow-ups, color Doppler ultrasound demonstrated normal perfusion, with no recurrence by 3 months. Conclusions: In recurrent torsion with a broad ligament fenestration, reduction + detorsion + closure of the defect with uterine oophoropexy may represent a pragmatic, fertility-sparing strategy, although longer follow-up is needed to confirm durability. To our knowledge—considering prior reports of up to seven ipsilateral recurrences—this represents the first report of 8 right-sided torsion episodes.
Öz et al. (Mon,) studied this question.