Ovarian torsion surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Conservative treatment of ovarian torsion includes laparoscopy to uncoil the torsed ovary and possibly oophoropexy to fixate the ovary which is likely to torse again. In severe cases, where blood flow is cut off to the ovary for an extended period of time, necrosis of the ovary can occur. In these cases the ovary must be surgically removed.

If there is no evidence of vascular compromise, or peritonitis then laparoscopy can be used to uncoil the torsed ovary.

If there is evidence of vascular compromise, or peritonitis, the salpingo-oophorectomy may be required. Unfortunately, the visual characteristics of the ovaries such as size, color, and edema may not accurately reflect the extent of injury. Therefore, most studies support a strategy of early conservative management, which is successful in 88% of cases.

Among young women in whom there is a long ligament, laparoscopic triplication of the utero-ovarian ligament has been utilized to reduce the risk of recurrent torsion. Patients with polycystic ovarian disease are also at risk of recurrence.

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