The main feature of torsion is ovarian enlargement due to venous/lymphatic engorgement, edema, and hemorrhage. Some causes of ovarian torsion may be related to an ovarian cyst, certain medications, pelvic surgery and pregnancy. It’s an emergency condition that needs urgent treatment in hospital to prevent permanent damage to your ovary. A sign is something that can be objectively measured, which means that it can be seen by someone else and a symptom, such as pain, cannot be. “And once we do make a diagnosis, we have the expertise to perform minimally invasive surgery.”. Fan. “If a patient has severe pelvic pain and is nauseous and I can feel the cyst during a pelvic exam, we will use transvaginal ultrasound to see if the ovary is enlarged, which could indicate torsion,” Dr. An ultrasound (usually a transvaginal one) can confirm the diagnosis. In the reproductive years, regular growth of large corpus luteal cysts are a risk factor for rotation. The pain is unilateral, i.e., on one side because ovarian torsion usually affects one ovary at a time. 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. Ovarian torsion usually affects one ovary at a time but there have been cases of bilateral torsion too. , Patients with ovarian torsion often present with sudden onset of sharp and usually unilateral lower abdominal pain, in 70% of cases accompanied by nausea and vomiting. Ultrasound is the initial imaging modality of choice. However, a large ovarian cyst can cause: 1. vomiting. This can be felt in the entire region or only on one side. Since other illnesses have similar symptoms, a health care provider will need to diagnose the cause of your symptoms.  The ovary will often recover, even if the condition has been present for some time.  While classically the pain is sudden in onset, this is not always the case. Previously, we had discussed the symptoms and causes of ovarian torsion. One study found Ovarian Torsion cases had a lower WBC, CRP, and Alvarado Score. Importantly, the critical ischemia time for the ovaries that results in necrosis is unknown. Always consider torsion when evaluating a female patient with abdominal pain, back pain, or flank pain. What are the symptoms of ovarian torsion? The incidence of ovarian torsion among women of all ages is 5.9 per 100,000 women, and the incidence among women of reproductive age (15–45 years) is 9.9 per 100,000 women. Fullness or heaviness in your abdomen 3. In 80%, torsion happens unilaterally, with slight predominance on the right. The mass effect of ovarian tumors is also a common cause of torsion.  Surgery is the most accurate method of diagnosis. Pelvic pain: Some women may initially feel intermittent cramps in their pelvic area for a few days or weeks. Signs and Symptoms of Ovarian Torsion Abrupt onset of acute/intense pain which is usually unilateral in the lower abdomen. Contact us to talk with a fertility expert and determine an effective plan of action if you are experiencing symptoms of this complication. The sudden pain is often preceded by occasional cramps for several days, or sometimes, for weeks (often because the ovary twists and untwists repeatedly). , Treatment is by surgery to either untwist and fix the ovary in place or to remove it. Occasionally, this can be a difficult diagnosis to make as some conditions, such as kidney stones or diverticulitis, may also give you pelvic pain.”. This page was last edited on 18 January 2021, at 19:33. Symptoms of ovarian torsion include a sudden onset of severe pain in the pelvis, nausea, and vomiting. , Ovarian torsion accounts for about 3% of gynecologic emergencies. [ncbi.nlm.nih.gov]  Symptoms typically include pelvic pain on one side. Bloating In these cases the ovary must be surgically removed.  The sensitivity and specificity of abnormal ovarian flow are 44% and 92%, respectively, with a positive and negative predictive value of 78% and 71%, respectively. Adnexal torsion is commonly unilateral, with a slight (3:2) right-sided predilection (presumably due to the protective effects of the sigmoid colon on the left) 6,8. Ovarian torsion is a great example of something you want to nip in the bud; it causes mild, easily mistaken symptoms for a long while, before suddenly turning into a major medical problem. A raised white cell count is common. Ovarian torsion after hysterectomy is a rare event. , Ovarian torsion is difficult to diagnose accurately, and operation is often performed before certain diagnosis is made. , Gynecologic ultrasonography is the imaging modality of choice. “Overall, it is a straightforward procedure that doesn’t typically take very long and most women recover fine.”. 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