In intermittent ovarian torsion due to an ovarian cyst, what is the recommended surgical management to preserve ovarian function?

• A. Oophorectomy
• B. Laparoscopic detorsion only
• C. Ovarian cystectomy
• D. Total abdominal hysterectomy

Answer: (C)

When torsion is caused by an ovarian cyst, the goal is to relieve the twist and address the underlying lesion while preserving the ovary. Removing the cyst (ovarian cystectomy) achieves this: it eliminates the mass that predisposed the ovary to twist, reducing the chance of recurrence, and leaves the ovarian tissue intact to maintain hormonal function and fertility. If you only untwist the ovary without removing the cyst, the cyst remains as a repeating risk factor for future torsion. Conversely, removing the ovary or the uterus would unnecessarily sacrifice reproductive organs in a situation where the ovary is still viable. In a patient with intermittent torsion due to a cyst, cystectomy performed laparoscopically is the approach that best preserves ovarian function.