Should You Be Concerned Over Twisted Ovaries?

Ovarian torsion is a condition in which a person has a twisted ovary which can cause severe pain. The twisting prevents blood from flowing to the ovary and fallopian tube. If the patient doesn’t seek immediate medical attention and treatment, tissue death can occur. 

We may also refer to it as adnexal torsion, and sometimes it can be difficult to diagnose, as people with this condition have the same symptoms that other conditions cause.

This blog will explore what causes twisted ovaries and describe how we can diagnose the condition. We will also mention some twisted ovary symptoms, treatment options, and what happens after the patient is treated.  

How Common Is Ovarian Torsion?

Ovarian torsion is a rare condition that can occur in any age group, but it is more common in women aged 20-40 years. 

It is important to diagnose and treat the condition in its early stages, especially if it develops in childhood. This is because it can cause organ loss, infertility and affect pubertal development. 

Ovarian torsion can affect only one side, but a recurrence is possible in the same ovary or both ovaries. 

What Causes Twisted Ovaries?

This section answers one of the most asked questions: What causes twisted ovaries?

The factors and conditions that can increase the risk of twisted ovaries include:

• Polycystic ovaries: These can lead to swollen ovaries. Patients with polycystic ovaries can reduce the risk of having a twisted ovary by using hormonal birth control to reduce the cysts’ size. It is always best to discuss this with a healthcare provider, as they can suggest the best medication for your condition.
• Pregnancy: During ovulation, the follicle releases an egg and forms a hormone-secreting structure known as the corpus luteum. The corpus luteum breaks down if the woman doesn’t get pregnant and causes reabsorption in the body. When a pregnancy occurs, however, this fills with blood and can turn into a cyst. This is very common in early pregnancy, but it can sometimes lead to ovarian torsion.
• Hormonal medications: The use of hormone medication to trigger ovulation for infertility problems can develop cysts. These can increase the risk of twisted ovaries.
• Having a long ovarian ligament: This connects the ovary to the uterus.
• Assisted Reproductive Technology (ART): The hormones used for in vitro fertilization or ovulation induction can increase the risk of twisted ovaries. This is because they cause ovary enlargement or develop a lot of cysts. People who undergo ART procedures should discuss the risks with their doctors and seek medical help if they have twisted ovary symptoms.

How Do You Diagnose a Twisted Ovary?

People who have ovarian torsion pain and severe abdominal discomfort should seek immediate medical help. 

Doctors perform different tests to determine whether the patient has a twisted ovary, including:

• Pelvic exam: This helps us determine where the pain is coming from.
• Urine test: This confirms that the patient isn’t pregnant due to their symptoms. 
• Ultrasound: We perform an ovarian torsion ultrasound by inserting the probe inside the vagina, as it helps us view the patient’s ovaries, fallopian tube, and blood flow. This can also help us spot ovarian cysts. 
• Blood and urine tests: These can be useful as twisted ovary symptoms can be similar to other conditions. Therefore, these tests help us rule out other potential diagnoses, such as ectopic pregnancy, appendicitis, ovarian abscess, and urinary tract infections. 

What Are Some Twisted Ovary Symptoms?

Twisted ovary symptoms are similar to those of other conditions, such as kidney stones, appendicitis, gastroenteritis, and urinary tract infections. 

If you have a twisted ovary, you may experience the following:

• Nausea. 
• Pain in the lower abdomen.
• Nausea. 
• Vomiting.
• Fever. 
• Abnormal bleeding.

A twisted ovary symptom can present suddenly or without warning, and abdominal pain can come and go for several weeks. This happens when the ovary is attempting to twist back to its position. 

The following section describes the treatment options available for patients who have a twisted ovary symptom. 

How Do You Treat a Twisted Ovary?

Surgical procedures are the only option for twisted ovary treatment. If you have a cyst, we first try to remove it and untwist the ovary or fallopian tube, as this restores the blood flow to the ovary and fallopian tube.

Therefore, the surgeon performs one of the following twisted ovary treatment surgeries:

• Laparoscopy: During this procedure, we make a small incision and insert a slender, lighted instrument in the patient’s lower abdomen, as this helps us view the internal organs. We also make another incision to be able to access the ovary, and after that, we untwist it using a blunt probe. We recommend a laparoscopy for pregnant women, and it requires general anesthesia and is performed on an outpatient basis. 
• Laparotomy: We make a larger incision in your lower abdomen so we can untwist the ovary manually. This procedure requires general anesthesia and is performed on an inpatient basis. 
• Oophorectomy: This involves the removal of the ovary if it is no longer functional.
• Salpingo-Oophorectomy: During this procedure, the surgeon removes both the ovarian and fallopian tissue as they are no longer viable. This can be the best option to prevent recurrence in postmenopausal women.

The surgeons always try to save the ovary. However, if it has been twisted for a long time, the best option would be to remove it with the fallopian tube, decreasing women’s ability to have children. However, if we don’t remove the ovary, you’re more likely to develop an infection that can cause an abscess.

The risk of recurrence is low.  

Now that we have covered the twisted ovary treatment section, we can explain what happens after undergoing a surgical procedure. 

What Happens After Surgery?

The doctor may recommend that you avoid heavy lifting or intense exercises for the first few weeks. You can even take over-the-counter medications to relieve pain and discomfort, such as ibuprofen. 

The physician may also prescribe oxycodone or oxycodone with acetaminophen if you have severe pain. Hormonal birth controls may also be helpful to reduce the recurrence of ovarian torsion.

When To Contact a Medical Professional

It is best to contact a medical professional if you have any symptoms that include ovarian torsion pain, abnormal bleeding, and symptoms of an ovarian cyst. 

Patients can experience symptoms if a cyst ruptures. These include:

• Pelvic pain.
• Pain during intercourse.
• Bloating.
• Swollen tummy.
• Heavy and irregular periods. 
• A frequent need to urinate. 
• Difficulty getting pregnant.  

If you experience any of the following symptoms associated with an infection after surgery, seek immediate medical help:

• Fever.
• Increasing pelvic pain.
• Inflammation in the incision sites.
• A foul-smelling discharge. 

Book Your Appointment Today

Having a twisted ovary is considered a medical emergency, and we can only correct it through a surgical procedure. 

If we don’t provide a diagnosis or treatment plan immediately, the risk for complications increases, and you’ll require more surgeries. 

Therefore, if you are experiencing any symptoms related to this condition, call our office to book an appointment with Dr. Ellman’s team at Women’s Healthcare of Boca Raton.