From
Grand Rounds
Ovarian Torsion with Dr. Dasgupta
With Dr. Roshni Dasgupta
Part of
Ovarian Torsion 8 items
Chapter 1 of 3 · Fundamentals
Practice patterns
Introduction and Current Practice Patterns in Ovarian Torsion Management
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
General surgeons do not do a good job in ovarian preservation compared to gynecology colleagues.
Oophorectomy rates were higher in non-teaching hospitals, younger patients, and in the south.
Recent data from last year show that one quarter of patients with ovarian torsion still get oophorectomies despite evidence against it.
Even if the ovary remains black after waiting 5 or 10 minutes or longer, it should be left alone.
Ovaries have dual blood supply and almost all are salvageable, so they should not be taken out.
If there is concern for a mass, a three-week ultrasound should be performed and the surgeon can return to the operating room if needed.
A torsed ovary should be untwisted, left alone, and the surgeon can come back another day if needed.
Taking out an ovary increases early menopause by seven years.
Removing an ovary can affect fertility rate.
If the child is not sick, the ovary can be left in place regardless of appearance after detorsion.
Pexy is not indicated in the majority of patients with ovarian torsion.
Follow-up ultrasound is indicated, especially if there is concern for a mass.
Gynecologists are much more likely to perform ovarian preservation than pediatric general surgeons.
Ovarian preservation should be considered even in neoplastic tumors and ovarian torsion where the ovary might be salvageable.
In a series of 2,041 patients from 2000 to 2014 with ovarian torsion, about 15% underwent detorsion only.
In the same series, almost 80% of patients with ovarian torsion had an oophorectomy.
In ovarian torsion, the ovary should be untwisted and observed to see if it pinks up.
A Cochrane review showed that ovarian pexy can actually cause more problems and is probably not indicated unless there is a really spread out broad ligament or some other reason for torsion.