Ovarian Torsion: Could This Happen to You? Let's Talk!

Have you ever had a sudden, severe stomach ache? Especially in the lower abdomen? Sometimes we think that this kind of pain is normal. However, sometimes it can be a medical emergency. One such emergency is ovarian torsion, or ``Ovarian Torsion''. Let's talk about this in a little more detail today, because this is something you, as a woman, need to know.

What is ovarian torsion?

Simply put, Ovarian Torsion is when one of your ovaries twists and turns around the tissue that holds it in place. As you know, the ovaries are two very important organs in a woman's reproductive system. They are two egg-shaped glands located on either side of the uterus. During your fertile period, these ovaries release eggs and produce hormones that regulate your menstrual cycle and pregnancy. These ovaries are suspended in the pelvic cavity by bands of tissue called ligaments.

Imagine what happens when this ovary twists like that. The blood supply to the twisted ovary is cut off, which can damage it. This is what causes sudden, unbearable pain in the lower abdomen. If emergency medical treatment is not sought at a time like this, the ovarian tissue can die and the ovary can be completely lost. This is why this is a very serious condition.

Sometimes, not only the ovary, but also the fallopian tube nearby can twist. In this case, this condition is called adnexal torsion.

How common is this condition?

Researchers are unsure exactly how common ovarian torsion is in the general population. However, studies have shown that it is the fifth most common reason for emergency gynecological surgery. It is estimated that only 3% of emergency department visits for surgical procedures related to the female reproductive system are for ovarian torsion.

What are the symptoms? How to recognize it?

The main symptom of this condition is sudden, severe lower abdominal pain. But, abdominal pain is a symptom of so many other diseases, right? We don't rush to the emergency room for all of them. However, in this case of `(Ovarian Torsion)`, going to the hospital quickly gives you a great chance of saving your ovary.

Other symptoms that can be identified are:

• Moderate to severe pain in the lower abdomen.
• Nausea and vomiting.

Now, there are some signs that suggest that ovarian tissue is starting to die. These are:

• Fever.
• Abnormal vaginal bleeding or other discharge.

How does this pain feel?

Pain is experienced differently by everyone. So it can be difficult to know exactly whether the pain you are experiencing is an emergency like `(Ovarian Torsion)` or something else. However, most people usually describe the pain of `(Ovarian Torsion)` as moderate to severe. That is, it is a very noticeable pain that is difficult to ignore.

This pain can look like this:

• Sharp, stabbing pain (this is the most common) or dull, cramping pain in the stomach.
• Pain throughout the lower abdomen (this is also common) or pain only on the side where the twisted ovary is located (usually the right side).
• The pain may be limited to the lower abdomen, or it may radiate to the thighs, flanks, and lower back.
• The pain may be constant (this is common), or it may come and go from time to time (this is less common).

Although usually rare, sometimes these symptoms of `(Ovarian Torsion)` can be intermittent. That is, the pain comes, subsides for a while, and then comes back. Sometimes the ovary can twist and then just stretch again. When it twists, the bleeding stops and the pain comes. When it stretches again, the bleeding starts and the pain subsides. Because of this intermittent nature, you may not be able to imagine what is happening. However, even if the pain comes from time to time, if you have `(Ovarian Torsion)`, you should definitely see a doctor and get treatment.

Why are these ovaries twisting? What are the reasons?

Simply put, Ovarian Torsion occurs when the balance that keeps the ovary in place is disrupted for some reason. For example, if there is a tumor in the ovary, such as an ovarian cyst (especially a large one), it adds extra weight to the ovary. Then it is more likely to rotate and twist around the ligament that it is attached to. Although this is not common, cancerous tumors or other solid masses in the ovary can also cause this weight shift and twisting.

Who is most at risk for this?

There are some risk factors that can contribute to the development of this condition, Ovarian Torsion. Let's see what they are:

• Age: About three-quarters of people diagnosed with this condition are in their reproductive years. This means it is most common in people between the ages of 29 and 34. However, anyone with ovaries (even a fetus in the womb) can develop this condition.
• Ovarian cysts: About 85% of people diagnosed with ovarian torsion have ovarian cysts or other benign tumors. The risk is higher if the tumor is 5 centimeters (about 2 inches) or larger.
• Longer than normal ovarian ligaments: Some people are born with slightly longer ligaments. These people are also at higher risk.
• Pregnancy:About a quarter of those diagnosed with Ovarian Torsion are pregnant. This risk may increase due to changes in the body during pregnancy. For example, corpus luteum cysts are more common during pregnancy. Also, hormonal changes can cause ligaments to become looser, making them more likely to twist.
• Fertility treatments: Treatments that stimulate the ovaries to release more eggs (ovulation) increase the risk of developing follicular cysts. A follicle is a sac inside the ovary that releases an egg. It is normal for cysts to form in this follicle during ovulation. So, the more active the follicles, the higher the risk of developing cysts.

Could something be causing this to happen all of a sudden?

Sometimes, certain movements in your body can trigger the symptoms of Ovarian Torsion. For some people, these symptoms may occur after sex or after strenuous physical activity.

But remember, it doesn't necessarily have to be a special event for Ovarian Torsion to occur.

What complications can occur if left untreated?

Most of the time, ovarian torsion resolves without complications when treated. However, if not treated promptly, the blood supply to the ovary can be cut off and the tissue can die. Although it is possible to get pregnant with just one ovary, studies have shown that removing an ovary due to ovarian torsion may reduce the chances of getting pregnant.

Although this is very rare, the dead tissue can cause an infection in the abdomen (peritonitis). If not treated immediately, this infection can spread to other organs and even the bloodstream. That's why prompt treatment is so important.

How is the diagnosis made?

Ovarian torsion can usually be diagnosed with a transvaginal ultrasound, which shows that the ovary is not getting enough blood flow. However, the only way to know for sure is if a surgeon can see the twisted ovary inside your body. Most often, they will look directly at your ovaries using a procedure called a laparoscopy. If they see that you have ovarian torsion during a laparoscopy, they can treat it right away.

What are the treatments?

Surgeons treat ovarian torsion by straightening the twisted ovary. They can also remove any cysts that may be causing it (ovarian cystectomy). Your ovary can usually be saved.

Most often, surgeons use a procedure called a laparoscopy to treat ovarian torsion. In this procedure, they make several small incisions in your abdomen. They insert a device called a laparoscope through one of the incisions to see if your ovary is twisted. If ovarian torsion is confirmed, surgery is performed through those same incisions to correct the problem.

Sometimes an open surgery (laparotomy) may be necessary. After a laparoscopy, you may be able to go home the same day. However, a laparotomy is a major surgery, so you may have to stay in the hospital overnight and recover longer.

What happens if you face this situation?

Many people with Ovarian Torsion are treated and return to their normal lives with two healthy, functioning ovaries. Surgery to lengthen the ovary is 90% successful.

However, if the surgeon suspects that the tissue has been damaged or that the cyst is due to a cancerous tumor, he or she may recommend removing the ovary. However, this is less common.

Are there ways to prevent this?

There is actually no specific way to prevent Ovarian Torsion.

But if you continue to have ovarian torsion (which is very rare), your doctor may recommend a surgery called an oophoropexy. This is done to stabilize the ovary so that it doesn't twist.

Some medical experts recommend this ``oophoropexy`` surgery for children who have lost one ovary due to ``Ovarian Torsion`` during childhood. It preserves the remaining ovary and allows them to have children in the future if they want to. Experts are still studying the benefits of ``oophoropexy`` in such cases.

When should I go to an Emergency Treatment Unit (ETU) ?

If you have unexplained lower abdominal pain, especially if you already know you have an ovarian cyst, which increases your risk of ovarian torsion, go to an emergency room (ETU) immediately.

Experts can't say exactly how long it takes for the tissue to die after the ovary has ruptured and symptoms begin. That's why it's important to be on the safe side. The sooner you see a doctor and get a diagnosis, the better the chances of a successful outcome.

What questions should I ask my doctor?

If you experience this condition, it's a good idea to ask a doctor these questions:

• What activities should I avoid while I recover from surgery?
• When should I come back to check on my recovery?
• What are the chances of me developing Ovarian Torsion again?
• Will this surgery affect my fertility?
• What are the signs of a complication that I should look out for?

Could this be life-threatening?

Ovarian torsion is usually not life-threatening, but it can happen. Very rarely, a dead ovary can lead to a serious infection if left untreated. However, the worst that can happen to most people is the loss of an ovary.

Prompt treatment can prevent the worst of these things, such as the loss of a limb or the development of a life-threatening infection.

How long can you not know if this has been around?

Most people with ovarian torsion see a doctor within one to three days of the onset of symptoms. However, there have been reports of people with intermittent torsion going undiagnosed for months. This is when the ovary twists and stretches again, causing pain that comes and goes.

But, without an official diagnosis, there's no way to know if this is the cause of your pain. Time is of the essence here. If you have symptoms, don't wait. Go to an emergency room as soon as possible.

Will this get better on its own?

It's possible, but very rare.

In intermittent ovarian torsion, the ovary twists and untwists in a pattern that eventually causes the ovary to return to its normal (untwisted) state.

But, never assume that `(Ovarian Torsion)` will get better on its own. This is not something that can be left to chance. If you have symptoms, go to an emergency room immediately.

When you have a symptom like lower abdominal pain, it can be frustrating and scary to not know if it's something minor or something that needs immediate medical attention. In the case of ovarian torsion, there's no way to know if the pain is caused by a twisted ovary until your doctor diagnoses it. Unfortunately, many people don't even know they have a (often harmless) condition called an ovarian cyst, which is a risk factor for ovarian torsion.

Don't take any chances. If you have severe lower abdominal pain, get medical attention immediately. Acting quickly can save your ovaries. It can also save your life.

So, what are the most important things we need to remember from this?

Okay, so, from what we've talked about today about Ovarian Torsion, here are the most important things to keep in mind:

• If you experience sudden, severe lower abdominal pain, nausea, and vomiting, don't take it lightly. This could be Ovarian Torsion.
• This is a medical emergency. There is a good chance that you can save your ovary by going to the hospital without wasting time.
• This risk is slightly higher for people with ovarian cysts, pregnant women, and those undergoing fertility treatment. However, it can occur in anyone.
• The usual treatment is to open the twisted ovary using a laparoscopy. In most cases, the ovary can be saved.
• Never wait for "this will get better on its own." Seek medical advice as soon as you feel pain.

Remember, the best way to stay healthy is to pay attention to your body and take action when you notice anything unusual. If you have any further questions about this, don't be afraid to talk to your doctor.

` Ovarian Torsion, Abdominal Pain, Gynecological Emergencies, Ovarian Cysts, Laparoscopy, Women's Health