Can a 2-centimeter ovary undergo torsion in the setting of a total hysterectomy (surgical removal of the uterus)?

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From the Research

Yes, a 2cm ovary can potentially torse (undergo torsion) even after a hysterectomy. Ovarian torsion occurs when an ovary twists around its supporting ligaments, cutting off blood supply. This remains possible after hysterectomy if the ovaries were preserved (a procedure called hysterectomy with ovarian conservation) 1. The risk factors for torsion include the presence of ovarian cysts, which can make the ovary heavier and more likely to twist. Symptoms of ovarian torsion include sudden, severe pelvic pain, nausea, vomiting, and sometimes fever.

Key Considerations

  • Ovarian torsion is an urgent event that requires immediate medical attention to prevent ovarian necrosis 2.
  • Diagnosis typically involves ultrasound with Doppler flow studies to assess blood flow to the ovary.
  • Treatment usually requires surgical intervention, often laparoscopic surgery, to untwist the ovary if viable or remove it if tissue damage is extensive 3, 4.
  • The decision to preserve or remove the ovaries during hysterectomy should consider the patient's age, medical history, and risk factors for ovarian cancer and other conditions 1.

Management Approach

  • Laparoscopic surgery is the preferred approach for treating ovarian torsion, as it allows for minimally invasive detorsion and adnexal sparing 2.
  • A stepwise strategy can be used to facilitate post-hysterectomy salpingo-oophorectomy, including pelvic and abdominal exploration, restoring normal anatomy, and identification of the ureter 3.
  • Patients who have undergone hysterectomy with ovarian conservation should be aware of the symptoms of ovarian torsion and seek emergency medical care promptly if they occur.

References

Research

Laparoscopy versus laparotomy for detorsion and sparing of twisted ischemic adnexa.

JSLS : Journal of the Society of Laparoendoscopic Surgeons, 2003

Research

A Stepwise Strategy to Minimally Invasive Salpingo-Oophorectomy in the Post-Hysterectomy Patient.

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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