Women suffering from adnexal torsion experience severe pain. Oftentimes, the only remedy is to remove the ovary and fallopian tube making it impossible to have a child.

What Is Adnexal Torsion?

Adnexal torsion is an uncommon condition in the reproductive system of women characterized by abrupt, sharp, and severe pain due to the twisting of the ovary and sometimes also the fallopian tube on the tissues around them. Adnexal torsion oftentimes occurs in women of reproductive age. Ovarian abnormalities are usually the cause.

The conditions that may trigger adnexal torsion are swelling of the ovary due to tumor or cyst, being pregnant, and the use of hormones to make ovulation happen in women who have fertility problems. Women can have this illness even without those causes as a normal ovary may twist. This rare condition usually happens to children. Usually, only one ovary is twisting. Sometimes the fallopian tube also twists.

What Happens to Women Who Have Adnexal Torsion?

Women who have adnexal torsion first experience recurring pain for days or sometimes weeks. Then the pain becomes severe, nausea, and vomiting follows. When the woman goes to a doctor, the doctor usually recommends ultrasonography. Ultrasonography makes diagnosis definite, and in the process, aids the doctor in knowing whether blood supply to the ovary has been stopped. If blood flow to the ovary has been stopped, its cells die. In this situation, surgery is needed. Surgery to remove the ovary and fallopian tube is called salpingo-oophorectomy. If blood flow to the ovary has not been stopped and no tissue was affected, the doctor may only perform laparoscopy and laparotomy, which are abdominal incisions done to untwist the ovary.

Laparoscopy uses a flexible viewing instrument inserted through the incision. By using another instrument, the doctor untwists the ovary and also the fallopian tube if it is twisted. Laparotomy, which is also done to untwist the ovary, creates a bigger opening and a viewing instrument is no longer necessary.

Aside from physical pain, emotional effects also happen to women with adnexal torsion. When ovaries are removed, the woman can no longer have children. This makes her incapable of having a normal family. She may later feel insecure and chronically stressed.

Proper Care for Women Who Have Adnexal Torsion

Central to the care for women who have adnexal torsion is the control or removal of pain. The use of analgesics is very important before and after surgery or gynecologic evaluation. Caring for women who suffer from adnexal torsion is generally divided into three: pre-hospital care, emergency room care, and care after treatment.

Pre-hospital care involves assessing vital signs and being alert if the patient has developed low blood pressure or rapid heart rate. Emergency room care involves managing pain, treating nausea and vomiting, and deciding whether to do incision procedures to untwist the ovary or to do a salpingo-oophorectomy. Care after treatment involves managing the wound and finding ways to aid physical and emotional healing.

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