When to operate nonreducible ovary?

During the period from 1992, to 1996, ninety three girls with incarcerated inguinal hernias, mean age 6 weeks, underwent operation at the Clinic for Paediatric Surgery in Novi Sad. All infant girls had incarcerated ovaries or ovaries and fallopian tubes inside hernia sacs. The nonreducible ovaries were present at the time of operation in 35 (37%) girls and in 5 the ovary and tube were twisted. The ovary and tube, were twisted and ischemic at the time of operation, requiring oophorectomy in 2 out of 5 girls. The results of this review and recent experiences reveal that nonreducible ovary is not at risk of compression of its blood supply, but at significant risk of torsion. That is why asymptomatic nonreducible ovary should be treated as every incarcerated hernia--with urgent reduction, manual or operative.