Ovarian Torsion Treatment in Turkey: Emergency Surgery to Save Your Ovary
What is ovarian torsion? Recognize symptoms like sudden severe pelvic pain and vomiting. Learn about laparoscopic detorsion surgery to save the ovary. Expert emergency care in Istanbul with Dr. Cengiz Andan.
A Race Against Time to Save Your Ovaries
Sudden, severe groin pain in women is not always just gas or a cold. Sometimes, this pain signals a critical condition called Ovarian Torsion (Twisted Ovary), where the ovary twists around its own ligaments, cutting off its blood supply.
This is one of the most urgent gynecological emergencies. Just as a heart attack cuts off blood to the heart, torsion cuts off blood to the ovary. If not treated within hours, the ovarian tissue can become gangrenous (die), necessitating the complete removal of the organ.
At Dr. Cengiz Andan’s Clinic in Istanbul, we rapidly evaluate every patient presenting with sudden abdominal pain. Our goal is to perform Emergency Laparoscopic Surgery to “untwist” and save the ovary before irreversible damage occurs.
- Why Does the Ovary Twist? Who is at Risk?
The ovaries are mobile organs suspended by ligaments within the pelvis. However, certain conditions can throw off the ovary’s balance, causing it to flip over its stalk.
Most Common Causes:
- Ovarian Cysts: The most common culprit. Cysts larger than 5 cm (especially Dermoid cysts) make the ovary top-heavy. Sudden movements, sports, or sexual intercourse can cause this weighted ovary to spin.
- Pregnancy: Hormones released during pregnancy loosen the ligaments, increasing the risk of torsion.
- Long Ovarian Ligament: Some women are born with naturally longer ovarian stalks.
- IVF Treatment: In cases of Ovarian Hyperstimulation Syndrome (OHSS), the ovaries become enlarged and heavy, increasing the risk of twisting.
- Symptoms: Pain “Like a Knife”
Ovarian torsion is usually a very dramatic event; the pain is often too severe to ignore.
- Sudden, Excruciating Pain: Typically on one side (right or left lower belly). It starts abruptly, comes in waves (colicky), and does not respond to standard painkillers.
- Nausea and Vomiting: Due to the intensity of the pain, vomiting occurs in about 70% of cases.
- Tenderness: The abdomen feels very sore to the touch.
- Fever: A low-grade fever may develop if the condition has been present for a while and tissue death (necrosis) has started.
- Diagnosis: Deciding Without Delay
Speed is everything in this scenario.
- Doppler Ultrasound: The most critical diagnostic tool. It measures blood flow in the vessels leading to the ovary. If there is no flow or reduced flow, the diagnosis of torsion is confirmed.
- Physical Exam: The doctor will check for signs of an “acute abdomen” (rigid belly).
- Treatment: Can the Ovary Be Saved?
The treatment for ovarian torsion is EMERGENCY SURGERY. Medication cannot untwist the ovary. Waiting leads to organ loss.
- Laparoscopic Detorsiyon (Untwisting):This is the Gold Standard. Through small incisions, the surgeon uses a camera to view the ovary.
- The Procedure: The twisted ovary is gently rotated back to its normal position (detorsion).
- The Wait: Once untwisted, we wait a few minutes. If the tissue is not dead, blood flow returns, and the ovary starts to turn pink again. In this case, the ovary is saved, not removed.
- Cyst Removal: If a cyst caused the twist, it is removed in the same session.
- Oophoropexy (Fixation): To prevent it from twisting again, the ovary may be stitched to the pelvic wall or ligament.
- Oophorectomy (Removing the Ovary):If the patient arrives too late and the ovary has turned completely black (necrosis/gangrene), it cannot be saved. It must be removed to prevent infection and toxins from spreading in the body.
- Recovery and Future Fertility
If the ovary is saved through early intervention, fertility is not affected. Even if one ovary must be removed, a woman can still conceive naturally and will not enter early menopause as long as the other ovary is healthy. Thanks to the laparoscopic technique, patients are usually discharged the next day and return to normal life within a week.
Dr. Cengiz Andan is by your side with 24/7 rapid diagnosis and organ-preserving surgical principles in cases of suspected ovarian torsion, aiming to protect your ovaries and future dreams of motherhood.
Frequently Asked Questions (FAQ)
- Can ovarian torsion fix itself?Answer:Very rarely, in cases of “partial torsion,” the ovary may twist and untwist on its own, causing intermittent pain. However, in a complete torsion, it cannot fix itself, and surgery is mandatory.
- How do you decide during surgery whether to remove the ovary?Answer:This decision is made by looking at the color of the ovary. After untwisting, we watch for 15-20 minutes. If the black/purple color starts to turn pink, it means the tissue is alive, and we save it. If it remains black, the tissue is dead and must be removed.
- Does torsion harm the baby if I am pregnant?Answer:Torsion itself does not harm the baby, but the severe pain and surgery can pose risks. However, laparoscopic surgery is safe during pregnancy, and the pregnancy can usually continue successfully.
- Can my ovary twist if I don’t have a cyst?Answer:Yes, though rare. It can happen especially in pre-pubescent girls or women with naturally long ovarian ligaments.
- Will it happen again after surgery?Answer:If the ovary is simply untwisted and left alone, there is a risk of recurrence. That is why we usually remove the cyst that caused it and, if necessary, stitch the ovary in place (fixation) to prevent future twisting.
