Sarcouncil Journal of Medical Sciences

Abstract: Background: Ovarian torsion is a critical gynecological emergency that demands rapid diagnosis and immediate surgical management to prevent tissue necrosis and preserve ovarian function. Over recent decades, clinical management has underwent a significant evolution from radical surgery to fertility-preserving, conservative approaches. Objective: This bibliographic analysis aimed to evaluate the scientific literature on ovarian torsion published between 1990 and 2025, tracking historical developments, current clinical trends, and identifying prominent gaps in existing research. Methods: A comprehensive literature search was conducted across major electronic databases (PubMed, Scopus, Web of Science, and Google Scholar) using targeted keywords related to ovarian torsion, diagnostics, and surgical interventions. Peer-reviewed clinical studies, reviews, and case reports published in English were selected based on strict inclusion and exclusion criteria, followed by a qualitative synthesis of the data. Results: The bibliographic analysis revealed a substantial increase in publications over the past thirty years, alongside a clear paradigm shift from radical oophorectomy to conservative laparoscopic detorsion. While Doppler ultrasonography remains the primary diagnostic modality, the literature underscores that normal blood flow cannot entirely exclude torsion, highlighting an ongoing diagnostic challenge. Laparoscopic detorsion was consistently associated with shorter hospital stays, quicker recovery, and successful preservation of ovarian viability, even in cases presenting with initial ischemic appearance. Furthermore, research focusing on pediatric and adolescent populations has steadily grown due to the vital importance of protecting future reproductive potential. Conclusion: The management of ovarian torsion has successfully transitioned toward minimally invasive, fertility-conserving approaches. However, the current body of literature remains limited by a lack of standardized diagnostic criteria, a scarcity of randomized controlled trials, and insufficient long-term follow-up data regarding future fertility outcomes. Continued research in these areas is crucial to optimize clinical decision-making and patient care.