Medicines for Ovarian torsion

What it is

Ovarian torsion is when an ovary (and often the tube next to it) twists around the ligaments that support it, which can cut off or reduce its blood supply. It is a surgical emergency, because, like a twisted testicle, an ovary deprived of its blood supply can be permanently damaged if the twist is not relieved promptly. It typically causes sudden, severe pain on one side of the lower tummy or pelvis, which may be constant or come in waves, and is often accompanied by nausea and vomiting; sometimes there is a preceding history of similar, milder episodes (from the ovary twisting and untwisting). It is more likely when an ovary is enlarged, for example by an ovarian cyst or during ovarian stimulation for fertility treatment, as the extra weight makes twisting more likely; it can also occur in pregnancy. Because sudden severe pelvic pain has several possible causes (some also serious, such as an ectopic pregnancy or appendicitis), and because ovarian torsion is time-critical, it needs urgent assessment. The key message is that sudden, severe one-sided pelvic pain, especially with nausea and vomiting, is a medical emergency requiring prompt evaluation.

How it is treated

Ovarian torsion needs urgent hospital assessment and treatment. Because saving the ovary depends on relieving the twist quickly, prompt evaluation is essential when it is suspected. Assessment includes examination, an ultrasound scan (which can show an enlarged ovary and assess its blood flow), and tests to exclude other causes of pelvic pain (including a pregnancy test, as an ectopic pregnancy must be excluded). Because scans cannot always definitively confirm or exclude torsion, and because delay risks losing the ovary, the diagnosis is often confirmed and treated with surgery — usually keyhole surgery (laparoscopy) — where the ovary is untwisted to restore its blood supply, and any underlying cause (such as a cyst) is treated; the aim is to preserve the ovary wherever possible, though if it is already too damaged it may need to be removed. Prompt surgery gives the best chance of saving the ovary. Pain relief and supportive care are provided. The overriding message is that ovarian torsion is a surgical emergency — sudden, severe one-sided pelvic pain, particularly with nausea and vomiting or an known ovarian cyst, needs immediate assessment, as quick treatment can save the ovary.