Ovarian Torsion: Causes, Symptoms, Diagnosis & Treatment

Ovarian torsion is a situation that arises when an ovary twists around the tissues that support it in place. Sometimes, the fallopian tube is also likely to get twisted. The blood supply to the ovary and the fallopian tube gets cut off in such a painful condition.

In medical language, doctors call this condition as adnexal torsion. Due to the lack of sufficient blood in these organs, severe pain and other symptoms could occur. If the blood restriction persists for a longer duration, it can then lead to tissue death and if not treated on time, chances of losing an ovary are high. Usually, only one ovary gets affected in ovarian torsion.

There is no clarity on how often would ovarian torsion happen. However, doctors agree that it is difficult to identify the same. In case if you have ovarian cysts, you are more likely to experience ovarian torsion. In such conditions, the ovary tends to swell.

Reading further could probably be a guide to gauge which symptoms to look for and how to overcome or reduce the overall menace.

Let us begin by identifying the causes:

Ovarian torsion is observed in the age group of 20 to 40 years. There is no age factor for women. During any stage between infancy to post-menopause, a woman can experience ovarian torsion.
It can get dislocated either due to swelling or other tissue mass in the ovary. The excess heaviness on the ovary leads to twisting and revolving in and around its supporting ligaments.

Both pregnant and non-pregnant women can be affected by ovarian torsion. During pregnancy higher hormone levels can also relax tissues in the body, including the ligaments that hold the ovaries in place. If the ligaments are not taut, they may be more prone to twisting. Those undergoing hormonal treatments, usually for infertility where the ovary is stimulated are more likely to face it.

Signs And Symptoms

A sudden severe pain in the lower abdomen or pelvic area, pelvic mass, nausea, vomiting, fever, abnormal bleeding and cramping are a few signs that need immediate attention.

The symptoms of ovarian torsion are also those of kidney stones, appendicitis, a urinary tract infection, and gastroenteritis. Therefore diagnosing it is a challenging task. The symptoms just pop up suddenly without any word of warning.

One should always remember that this condition never occurs without a pain. There could be a possibility of pain, cramping, and tenderness often doing back and forth in the lower abdomen for several weeks. This then could probably be the situation when the ovary is attempting to twist back into the correct position.

If nausea or vomiting is experienced without any pain, then it is likely that you have a different underlying condition. Whatever be the condition, a visit to the doctor is a must for diagnosis.

So When Do We Consult A Doctor?

Seeking medical attention is very essential if a person sees any of the symptoms of ovarian torsion. It is the doctor who will diagnose the condition and take the necessary action to safeguard it. One should not try any home remedies and avoid the doctor. The sooner it is detected, better would be the treatment and repair.

Diagnosis Of Ovarian Torsion

It is only after assessing the symptoms and reviewing your medical history that the doctor will perform a pelvic exam to locate any areas of pain and tenderness. A transvaginal ultrasound will also be recommended to view the ovary, fallopian tube, and blood flow. An abdominal ultrasound, a complete blood count test, or CBC and other imaging tests, such as a CT scan or MRI scan may be recommended by the doctor to diagnose it.

In order to rule out other potential diagnoses such as urinary tract infection, ovarian abscess, ectopic pregnancy, and appendicitis few other blood and urine tests will also be suggested by the doctor. Only a preliminary diagnosis of ovarian torsion is possible with these findings. However, it is not possible for any doctor to entirely confirm the ovarian torsion without performing surgery to see the ovary.

Ways And Measures To Treat It

Surgery is the only option available for cure. An operation will be done to untwist your ovary, and if need be your fallopian tube would also be mended. Basically, there are two types of surgical procedures to untwist the ovary viz: laparoscopy or laparotomy. In both the cases, an incision will be done in your lower abdomen to allow access to the ovary.

Sometimes it becomes necessary to remove the affected ovary. Though not always, it usually would depend on how severe the damage is. Doctors generally opt for laparoscopy method in case if the woman is pregnant. Be it any type of surgery there is a risk in these procedures to contract blood clotting, infection, and complications from anaesthesia.

A few medications like high-dose birth control pills or other forms of hormonal birth control would be prescribed by your doctor to reduce the risk of recurrence. Some over-the-counter pain relievers would also be recommended by the doctor to help ease your symptoms during recovery: In case if the pain is very severe, then the doctor may prescribe opioids.

Will Ovarian Torsion Affect Reproduction?

A woman's ability to conceive does not get affected with an ovarian cyst. Polycystic ovary syndrome (PCOS) is the only condition in which ovarian cysts are linked with difficulty in conceiving.