Ovarian Torsion Symptoms Causes Treatment and More
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ncbi.nlm.nih.gov/pubmed/18794312Kolluru V, et al. (2009). Torsion of ovarian cyst during pregnancy: A case report.
ncbi.nlm.nih.gov/pmc/articles/PMC2809077/Shah AA, et al. (2009). Early polycystic ovary syndrome as a possible etiology of unexplained premenarcheal ovarian torsion.
pubmed.ncbi.nlm.nih.gov/19646674Yancey L, et al. (2019). Ovarian torsion.
saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-genitourinary/ovarian-torsionOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 21, 2022 By Corey Whelan Edited By Aline (Ren) Dias Medically Reviewed By Jenny Yu Copy Edited By Copy Editors Sep 29, 2018 By Corey Whelan Edited By Tracey Crate VIEW ALL HISTORY Share this articleMedically reviewed by Jenny Yu, MD FACS — By Corey Whelan — Updated on October 20, 2022
What Is Ovarian Torsion
Medically reviewed by Jenny Yu, MD FACS — By Corey Whelan — Updated on October 20, 2022Is it common
Ovarian torsion (adnexal torsion) occurs when an ovary becomes twisted around the tissues that support it. Sometimes, the fallopian tube may also become twisted. This condition cuts off the blood supply to these organs. Ovarian torsion is a medical emergency. If not treated quickly, it can result in the loss of an ovary. It’s unclear how often ovarian torsion occurs, but doctors agree it’s an uncommon diagnosis. You may be more likely to experience ovarian torsion if you have ovarian cysts, which can cause the ovary to swell. You may be able to reduce your risk by using hormonal birth control or other medications to help reduce the size of the cysts. Keep reading to learn which symptoms to watch for, determine your overall risk, when to see a doctor, and more.What are the symptoms
Ovarian torsion can cause:severe, sudden pain in the lower abdomencrampingnauseavomiting These symptoms usually present suddenly and without warning. In some cases, pain, cramping, and tenderness in the lower abdomen may come and go for several weeks. This can occur if the ovary is attempting to twist back into the correct position. This condition never occurs without pain. If you’re experiencing nausea or vomiting without pain, you likely have a different underlying condition. Either way, you should see a doctor.What causes this condition and who s at risk
Torsion can occur if the ovary is unstable. For example, a cyst or ovarian mass can cause the ovary to become lopsided, making it unstable. You may also be more likely to develop ovarian torsion if you:have polycystic ovary syndromehave a long ovarian ligament, which is the fibrous stalk that connects the ovary to the uterushave had a tubal ligationare pregnantare undergoing hormonal treatments, usually for infertility, which can stimulate the ovary Although this can happen at any age, it’s most likely to occur during reproductive years, which are generally between the first menstrual cycle and menopause.How is it diagnosed
If you’re experiencing symptoms of ovarian torsion, seek immediate medical attention. The longer the condition goes untreated, the more likely you will experience complications. After assessing your symptoms and reviewing your medical history, your doctor will perform a pelvic exam to locate any areas of pain and tenderness. They’ll also perform a transvaginal ultrasound to view your ovary, fallopian tube, and blood flow. Your doctor will use blood and urine tests to rule out other potential diagnoses, such as:urinary tract infectionovarian abscessectopic pregnancyappendicitis Although your doctor can make a preliminary diagnosis of ovarian torsion based on these findings, a definitive diagnosis is typically made during corrective surgery.What treatment options are available
Surgery will be done to untwist your ovary, and, if necessary, your fallopian tube. After surgery, your doctor may prescribe medication to reduce your risk of recurrence. Occasionally, it may be necessary to remove the affected ovary.Surgical procedures
Your doctor will use one of two surgical procedures to untwist your ovary:Laparoscopy: Your doctor will insert a slender, lighted instrument into a small incision in your lower abdomen. This will allow them to view your internal organs. They’ll make another incision to allow access to the ovary. Once the ovary is accessible, your doctor will use a blunt probe or another tool to untwist it. This procedure requires general anesthesia and is usually done on an outpatient basis. Your doctor may recommend this surgery if you’re pregnant.Laparotomy: With this procedure, your doctor will make a larger incision in your lower abdomen to allow them to reach in and untwist the ovary manually. This is done while you’re under general anesthesia, and you’ll be required to stay at the hospital overnight. If too much time has passed — and the prolonged loss of blood flow has caused the surrounding tissue to die — your doctor will remove it through either:Oophorectomy: If your ovarian tissue is no longer viable, your doctor will use this laparoscopic procedure to remove the ovary.Salpingo-oophorectomy: If the ovarian and fallopian tissue are no longer viable, your doctor will use this laparoscopic procedure to remove them. They may also recommend this procedure to prevent recurrence in postmenopausal women. As with any surgery, risks of these procedures may include blood clotting, infection, and complications from anesthesia.Medication
Your doctor may recommend over-the-counter pain relievers to help ease your symptoms during recovery, such as:acetaminophen (Tylenol)ibuprofen (Advil)naproxen (Aleve) If your pain is more severe, your doctor may prescribe opioids, such as:oxycodone (OxyContin)oxycodone with acetaminophen (Percocet) Your doctor may prescribe high dose birth control pills or other forms of hormonal birth control to reduce your risk of recurrence.Are complications possible
The longer it takes to receive a diagnosis and treatment, the longer your ovarian tissue is at risk. When torsion occurs, blood flow to your ovary — and possibly to your fallopian tube — is reduced. A prolonged reduction in blood flow can lead to necrosis (tissue death). If this happens, your doctor will remove the ovary and other affected tissue. The only way to avoid this complication is to seek immediate medical attention for your symptoms. If an ovary is lost to necrosis, conception and pregnancy are still possible. Ovarian torsion doesn’t affect fertility in any way.What s the outlook
Ovarian torsion is considered a medical emergency, and surgery is required to correct it. Delayed diagnosis and treatment can increase your risk of complications and may result in additional surgeries. Once the ovary has been untwisted or removed, you may be advised to take hormonal birth control to reduce your risk of recurrence. Torsion doesn’t have an impact on your ability to conceive or carry a pregnancy to term. Last medically reviewed on October 20, 2022How we vetted this article
SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Chang HC, et al. (2008). Pearls and pitfalls in diagnosis of ovarian torsion.ncbi.nlm.nih.gov/pubmed/18794312Kolluru V, et al. (2009). Torsion of ovarian cyst during pregnancy: A case report.
ncbi.nlm.nih.gov/pmc/articles/PMC2809077/Shah AA, et al. (2009). Early polycystic ovary syndrome as a possible etiology of unexplained premenarcheal ovarian torsion.
pubmed.ncbi.nlm.nih.gov/19646674Yancey L, et al. (2019). Ovarian torsion.
saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-genitourinary/ovarian-torsionOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 21, 2022 By Corey Whelan Edited By Aline (Ren) Dias Medically Reviewed By Jenny Yu Copy Edited By Copy Editors Sep 29, 2018 By Corey Whelan Edited By Tracey Crate VIEW ALL HISTORY Share this articleMedically reviewed by Jenny Yu, MD FACS — By Corey Whelan — Updated on October 20, 2022