What Is Ovarian Torsion?

Ovarian torsion refers to an unnatural twisting of a woman’s ovary around the ligaments supporting it, cutting off blood flow to the organ and sometimes to the fallopian tube as well. This loss of blood can result in tissue death and, if left untreated, organ failure. Also called adnexal torsion, ovarian torsion can be extremely painful and is considered a medical emergency. Though relatively rare, it is associated with several more common risk factors, including ovarian cysts and tubal ligations. Ovarian torsion can be difficult to diagnose, because its symptoms mimic those of other, more frequent medical conditions. 

It can occur at any age but is most common in women during their reproductive years. 

What Are Ovarian Torsion Symptoms?

The symptoms of ovarian torsion include:

• Severe lower abdominal pain
• Nausea
• Vomiting
• Cramping

Symptoms often present suddenly, without warning. 

Ovarian torsion often results in necrosis, or tissue death, and the loss of an ovary, with implications for a woman’s fertility. A failed ovary must be surgically removed to avoid the risk of a follow-on infection.

What Causes Ovarian Torsion?

Ovarian twisting typically occurs when the ovary becomes unstable, and alters position within its surroundings. Several factors can impinge on ovarian stability; for example, the development of a cyst can affect the organ’s weight distribution, causing it to shift location or orientation.  

Factors that increase the possibility of ovarian torsion are:

• Pregnancy
• Tubal ligations
• Hormone treatments for infertility
• Cyst development, including polycystic ovarian syndrome
• Unusually long ovarian ligaments

How Is Ovarian Torsion Diagnosed?

Ovarian torsion is a painful condition. If you’re experiencing severe abdominal discomfort, seek medical help immediately. 

The identification of ovarian torsion relies on tests developed for the diagnosis of various forms of abdominal pain. These include:

• Pelvic exam: A pelvic exam can help a physician determine your pain’s point of origin. 
• Urine test: Urine tests document evidence of infection and also rule out pregnancy as a cause of symptoms. 
• Blood work: Blood work can provide additional indicators of infection. 
• X-ray: X-rays reveal any relevant structural issues inside the abdomen. 
• Ultrasound: Ultrasounds can be useful in evaluating female reproductive health. The presence of a cyst or a lack of blood flow is often apparent in an ultrasound image of the ovaries. 

Your physician will use these tests to identify the source of your abdominal pain. Some of the other medical conditions that must be ruled out are constipation, ovarian abscesses, appendicitis, ectopic pregnancy, and urinary tract infections.

How Is Ovarian Torsion Treated?

Surgery has proven to be the only effective means of treating ovarian torsion. The surgical procedures employed include:

• Laparoscopy: A laparoscope is a long, slender tube with a light and tiny surgical tools attached to one end. It is introduced to the body through a small incision in the abdomen. A laparoscope can be used to relieve ovarian torsion. The procedure, which requires anesthesia but is less invasive than traditional surgery, is typically performed on an outpatient basis. 
• Laparotomy: A laparotomy is similar, but requires a larger abdominal incision to allow for manual untwisting of the ovary. Laparotomies are usually inpatient, overnight procedures. 
• Oophorectomy: If the ovary is no longer functional, it will be removed from the body by means of a laparoscope. 
• Salpingo-Oophorectomy: This procedure is the laparoscopic removal of both the ovary and the fallopian tube, which is also at risk from ovarian torsion. 

Your physician may prescribe pain-relief medications, including opioids, during recovery, depending on level of severity. 

If diagnosed and treated in a timely fashion, ovarian torsion poses only a minimal threat to a women’s reproductive health. If treatment is delayed, however, the medical consequences become more serious. 

Can Ovarian Torsion be Prevented?

There is no medically certain method for preventing ovarian torsion. However, using hormonal birth control may reduce the likelihood of its development, by limiting the physical impact of ovarian cysts on the reproductive system. 

Learn More About Ovarian Torsion from Baptist Health

For more information about ovarian torsion diagnosis and treatment, or to schedule an appointment with our physicians, please contact the Baptist Health women’s services team.