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Ovarian Torsion

Twisting of the ovary on its vascular pedicle — a gynaecological emergency

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Ovarian Torsion?

Ovarian (adnexal) torsion is rotation of the ovary around its vascular pedicle, causing venous congestion, oedema, and ultimately arterial ischaemia.

It most commonly affects reproductive-age women but can occur at any age, often on a pre-existing ovarian cyst (especially dermoid) or enlarged follicle.

Diagnosis is clinical, supported by pelvic ultrasound with Doppler — decreased or absent flow is suggestive, but normal Doppler does not exclude torsion.

Definitive diagnosis and treatment is by diagnostic laparoscopy; ovary-sparing detorsion is preferred even in dusky ovaries, as reperfusion often restores function.

Symptoms

Sudden severe unilateral pelvic pain
Nausea and vomiting
Lower abdominal tenderness with guarding
Low-grade fever as necrosis develops
Intermittent pain with partial torsion
Palpable tender pelvic mass

Risk Factors

Ovarian cyst or mass (especially dermoid)
Long utero-ovarian ligament
Pregnancy
Ovulation induction (large follicles)
Previous ovarian torsion
Vigorous physical activity or sudden movement

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden severe unilateral pelvic pain requires immediate emergency review
  • If nausea and vomiting accompany the pain
  • If a tender pelvic mass is palpable
  • If pain starts in a patient with a known ovarian cyst

Treatment Methods

01
Emergency laparoscopy: diagnosis and treatment in the same session
02
Detorsion with attempted ovarian preservation
03
Cystectomy if an underlying cyst is identified
04
Oophorectomy reserved for clearly necrotic, non-viable tissue
05
Oophoropexy to reduce risk of recurrent torsion
06
Early surgery preserves ovarian reserve and fertility

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.