Case report of ovarian transposition and review of literature

Objective Pelvic radiotherapy is frequently used to treat pelvic tumours in premenopausal women. As there is a high probability of premature ovarian failure in this situation, ovarian repositioning is often required. This can now be done laparoscopically. We aimed to develop a modified technique that maintained the relationship between the ovaries and the fallopian tubes for potential future conception without the requirement for further surgery. Setting A teaching hospital. Subject An 18-year-old girl with a medulloblastoma who after craniectomy required craniospinal irradiation. To avoid ovarian irradiation she was referred to our unit for ovarian transposition. Intervention At the time of laparoscopic surgery the utero-ovarian ligaments were divided and the ovaries were sutured as a unit to the psoas muscle without distortion of the fallopian tube. Result After surgery, X-ray examination revealed that the lateral displacement of the right ovary was insufficient and consequently the procedure was repeated on this side. The patient's gonadotrophin levels remained in the premenopausal range after surgery. Conclusion Ovarian transposition that maintains the relationship between the ovaries and fallopian tubes can be achieved by laparoscopic surgery.