Ovarian torsion is a serious and painful condition, which needs immediate management by Best Laparoscopic Surgeon in Lahore. As the name implies, ovarian torsion occurs when the ovaries twist around their supporting ligament. This condition, without management, can have serious consequences. Read on to know more about ovarian torsion and its correction through laparoscopic surgery:

What is ovarian torsion?

Ovaries are small almond shaped organs located on either side in the lower abdomen in women. Ovaries are part of the reproductive system and release female reproductive hormones—estrogen and progesterone—as well as an egg every month for fertilization. 

Ovaries are supported by ligaments and can become twisted around it. Along with the ovary, the fallopian tubes can be affected by torsion. If this lasts long enough, the blood supply to the ovaries and fallopian tubes is compromised. This, in turn, can cause tissue death (ovarian necrosis), infection of the abdominal cavity (peritonitis), loss of the ovary and even infertility. 

Ovarian torsion is also known as adnexal torsion and mostly affects one ovary at a time. Most cases of ovarian torsion occur in women of reproductive age group, but young girls are not immune to this condition. Other risks that predispose to ovarian torsion include:

• Enlarged ovary due to ovarian cyst 
• Pregnancy 
• Hormonal medication that trigger ovulation and stimulate the ovaries to develop cysts 

Ovarian torsion is a medical emergency, needing immediate surgery to untwist the ovary so the blood supply to the organ can be restored. According to Gynecologic specialist, Linda Fan, MD at Yale Medicine, full recovery can be made with timely treatment.  

What are the symptoms of ovarian torsion?

Ovarian torsion presents suddenly, and is an intensely painful condition. Other symptoms of ovarian torsion include:

• Sudden onset of severe pelvic pain 
• Nausea and vomiting 
• Cramping in the lower abdomen 
• Pain that radiates to the back and legs 
• Abnormal bleeding or discharge from the vagina 

Ovarian torsion can be difficult to diagnose because of overlapping conditions like:

• Gastroenteritis
• Kidney stones 
• Urinary tract infection
• Appendicitis 

The diagnosis of ovarian torsion is confirmed with symptoms and physical examination of the patient. Investigations that help with the diagnosis include transvaginal and abdominal ultrasound. Laparoscopy plays the role of both confirmatory investigation and treatment modality. Immediate laparoscopic surgery can confirm the twisting of the ovary and save it, as well. 

What are the treatment options?

The treatment of choice for ovarian torsion is untwisting of the ovary. This can be done through two types of surgeries:

• Laparotomy procedure to untwist the ovaries

In this procedure, the patient is put under general anesthesia and a large incision is made on the abdomen to access the pelvic organs. Thereafter, the surgeon manually untwists the ovary. This is a longer procedure that mandates overnight stay at the hospital. The recovery period for laparotomy procedure is more than laparoscopic surgery. 

• Laparoscopic untwisting of the ovaries 

In this procedure, the patient is put under general anesthesia and a small incision is made on the abdomen to insert the laparoscope to view the pelvic organs. Another small incision is made to access the ovaries. Once the ovaries are visible to the surgeon, they untwist the ovary and check for viability of the organ. 

If a lot of time has passed since the torsion, the blood supply may be compromised and the surgeon may have to remove the necrosed ovary. This procedure is called laparoscopic oophorectomy. 

If the fallopian tubes are also affected by torsion, they may have to be removed as well. This procedure is called salpingo-oophorectomy. 

Laparoscopic procedure is a minimally invasive procedure, with shorter operative procedure, lesser bleeding and smaller recovery time. The pain experienced by the patient is also less as compared to an open surgical procedure. For treating ovarian torsion, the Laparoscopic Surgeon in Karachi performs this surgery on outpatient basis. Soon thereafter, the patient is discharged. This procedure is also suitable if the patient is pregnant.