The reason you have pelvic pain: there is a twist

August 30, 2018



Pelvic pain has many causes, and one of the most confusing diagnosis  is tubal torsion. It is literally twisted internal organ(s), usually the fallopian tube, and usually because there is a cyst that gets lodged and cannot be mobile.



When you and your gyno are sorting out the problem there may be a twist to the diagnosis that you haven't yet appreciated! Often we say that infections are hard enough to diagnoses as culture tests done of the vagina and cervix cannot reliably tell you whether there is infection in the uterus, the ovaries or the fallopian tubes.


The baffling case of a woman who may feel well one day and then be in severe pain the next may have a condition called tubal torsion, ovarian torsion, or in some cases tuboovarian torsion.


The pain is caused by a twisting of pelvic structures so that there is pain when they are twisted. For women who have no scaring that keeps the twist in place the tissue then relaxes back into it's natural position, and the pain is resolved.


On pelvic examination or ultrasound when there is no torsion, there are no findings of any abnormalities. But when the torsion goes on long enough, the tissue becomes deprived of oxygen and there is pelvic pain. If the torsion is severe enough to cause ongoing pain only surgery can resolve the pain.


The type of surgery will depend upon the patient and her situation. Conserving one's ovaries is the goal of most gynos when treating tubal and ovarian torsion, and the more quickly the correct diagnosis is established, the more likely the tube and ovary can be save

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