When the ovary becomes twisted on itself or on the fallopian tube, this is known as ovarian torsion or adnexal torsion. It’s serious, but typically not life-threatening, medical emergency that requires swift diagnosis and treatment. Torsion of the ovary can cause a blockage in the blood vessels, depriving the ovary of life-sustaining blood and oxygen. The longer the blood supply is cut off, the more damage may be done to the ovarian tissue.
Ovarian torsion is a rare condition, occurring in only about 6 per 100,000 women. It is slightly more common in young women.
Ovarian Torsion Symptoms
The surest sign of an ovarian torsion is a sudden, severe pain on one side of the lower abdomen, usually striking during exercise or other vigorous movement. Although some women report mild pain, the pain is usually severe and worsens over a period of a few hours. The pain is usually isolated to the affected ovary, but can radiate through the pelvis, back, and/or thigh.
Risk Factors for Ovarian Torsion
Women with enlarged ovaries and elongated fallopian tubes are at an increased risk for ovarian torsion. Such conditions can result from:
- Ovarian cysts and tumors
- Previous pelvic surgeries, especially tubal ligations
- Congenital malformations – typically found in young children diagnosed with ovarian torsion
Ovarian Torsion Diagnosis
If ovarian torsion is diagnosed and treated quickly, the chances of a successful recovery are quite high. However, most occurrences are diagnosed too late, and the ovary has already sustained too much damage.
Often if the signs point to ovarian torsion, doctors will recommend surgery before a certain diagnosis is made. This is because the process of diagnosis may take too long, prolonging the time the ovary is cut off from its blood supply.
Ovarian Torsion Treatments
There are two primary treatments for ovarian torsion.
A laparoscopy is a conservative surgical procedure which can correct an ovarian torsion if an early diagnosis is made. The surgeon will make one or more small incisions in the abdomen, and insert a laparoscope – a small, thin, flexible instrument with a lighted tip – into the surgical site to guide the correction procedure.
Surgical removal of the ovary
In most cases of ovarian torsion, the ovary cannot be salvaged. In these cases, the ovary and usually the fallopian tube must be surgically removed in a procedure called a salpingo-oophorectomy.
Complications of Ovarian Torsion
The most dangerous risk of an ovarian torsion is the cut off of the major blood vessels to the ovary. If the ovarian torsion is not treated quickly, there is a high likelihood that the ovary will have been starved of blood for too long and will have succumbed to necrosis. This usually means that the dead or dying ovary will need to be surgically removed from the body.
Fortunately, the condition is not life-threatening and research indicates that the loss of an ovary does not typically impact fertility in a significant way.