What is Ovarian Torsion?
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 painful condition cuts off blood supply to these organs. Ovarian torsion is a surgical emergency. If not treated quickly, it can result in loss of an ovary.
Symptoms
These symptoms usually present suddenly and without warning. If you’re experiencing nausea or vomiting without pain, you have a different underlying condition. Either way, you should see us for diagnosis.
Are you at risk ?
You may be more likely to develop ovarian torsion if you:
- Have polycystic ovarian syndrome
- Have a long ovarian ligament, which is the fibrous stalk that connects the ovary to the uterus
- Have had a tubal ligation
- Are undergoing hormonal treatments, usually for infertility, which can stimulate the ovary
- Have Ovarian Cyst.
Although this can happen to women and girls at any age, it’s most likely to occur during the reproductive years.
Diagnosis
If you’re experiencing symptoms of ovarian torsion, seek immediate medical attention. The longer the condition goes untreated, the more likely you are to experience complications.
After assessing your symptoms and reviewing your medical history, we 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. We will also use blood and urine tests to rule out other potential diagnoses, such as:
We will use one of two surgical procedures to untwist your ovary:
If too much time has passed — and the prolonged loss of blood flow has caused the surrounding tissue to die then we may do :
Complications
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 an ovary is lost to necrosis, conception and pregnancy are still possible with the other ovary.
You Should Know …
Ovarian torsion is considered a surgical 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.
Treatment we recommend:
Surgery will be one to untwist your ovary and if necessary your fallopian tube. Occasionally it may be necessary to remove the ovary. After surgery, we prescribe medication to reduce the risk or recurrence. If the untwisting procedure does not restore the blood supply to the ovary or if the ovary is already severely damaged then it is removed.
Usha may use one of these two surgical procedures to untwist our ovary:
- Laparoscopy: This is done in the well equipped OT and requires general anaesthesia. Ovary is untwisted using an instrument making a small incision in the abdomen. We may recommend this procedure even if you are pregnant.
- Laparotomy: Here an overnight stay is required as the procedure is done manually to untwist the under ovary, under general anaesthesia making a large incision in the abdomen.
If the prolonged blood loss has caused the surrounding tissue to die, then we may have to remove the ovary.
- Ovariotomy: If the ovarian tissue is no longer viable, then we may use laparoscopic procedure to remove the ovary.
- Salpingo Ovarectomy: If both the ovarian and fallopian tissue are no longer viable then laparoscopically we may have remove both these.
As with any surgery the risks may include blood clotting, infection and complications from anaesthesia.