40:
267:
The development of an ovarian mass is related to the development of torsion. In the reproductive years, regular growth of large corpus luteal cysts are a risk factor for rotation. The mass effect of ovarian tumors is also a common cause of torsion. Torsion of the ovary usually occurs with torsion of
242:
Treatment is by surgery to either untwist and fix the ovary in place or to remove it. The ovary will often recover, even if the condition has been present for some time. In those who have had a prior ovarian torsion, there is a 10% chance the other will also be affected. The diagnosis is relatively
397:
Ovarian torsion accounts for about 3% of gynecologic emergencies. The incidence of ovarian torsion among women of all ages is 5.9 per 100,000 women, and the incidence among women of reproductive age (15–45 years) is 9.9 per 100,000 women. In 70% of cases, it is diagnosed in women between 20 and 39
280:. In 80%, torsion happens unilaterally, with slight predominance on the right. In ovarian torsion, the ovary rotates around both the infundibulopelvic ligament (ie, suspensory ligament) and the utero-ovarian ligament (i.e. ovarian ligament), disrupting blood flow to the ovary.
398:
years of age. The risk is greater during pregnancy and in menopause. Risk factors include increased length of the ovarian ligaments, pathologically enlarged ovaries (more than 6 cm), ovarian masses or cysts, and enlarged
771:
Zanforlin Filho SM, Araujo Júnior E, Serafini P, Guimarães Filho HA, Pires CR, Nardozza LM, Moron AF (April 2008). "Diagnosis of ovarian torsion by three-dimensional power
Doppler in first trimester of pregnancy".
999:
984:
340:
Normal vascularity does not exclude intermittent torsion. There may occasionally be normal
Doppler flow because of the ovary's dual blood supply from both the ovarian arteries and uterine arteries.
385:
to uncoil the torsed ovary and possibly oophoropexy to fixate the ovary which is likely to twist again. In severe cases, where blood flow is cut off to the ovary for an extended period of time,
1088:
669:
Bar-On S, Mashiach R, Stockheim D, Soriano D, Goldenberg M, Schiff E, Seidman DS (April 2010). "Emergency laparoscopy for suspected ovarian torsion: are we too hasty to operate?".
1900:
1081:
928:
Yuk JS, Kim LY, Shin JY, Choi DY, Kim TY, Lee JH (May 2015). "A national population-based study of the incidence of adnexal torsion in the
Republic of Korea".
571:
307:
in the diagnosis has been suggested. However, doppler flow is not always absent in torsion – the definitive diagnosis is often made in the operating room.
1074:
893:
Eckler K, Laufer MR, Perlman SE (August 2000). "Conservative management of bilateral asynchronous adnexal torsion with necrosis in a prepubescent girl".
251:
Patients with ovarian torsion often present with sudden onset of sharp and usually unilateral lower abdominal pain, in 70% of cases accompanied by
858:
Crouch NS, Gyampoh B, Cutner AS, Creighton SM (December 2003). "Ovarian torsion: to pex or not to pex? Case report and review of the literature".
438:
243:
rare, affecting about 6 per 100,000 women per year. While it most commonly occurs in those of reproductive age, it can occur at any age.
288:
Ovarian torsion is difficult to diagnose accurately, and operation is often performed before certain diagnosis is made. A study at an
824:
1875:
314:
seems to be a good predictor of ovarian torsion. Women with pathologically low flow are more likely to have torsion. The
1519:
631:
1689:
1208:
599:
196:
on one side. While classically the pain is sudden in onset, this is not always the case. Other symptoms may include
1394:
1303:
232:
496:
Robertson JJ, Long B, Koyfman A (April 2017). "Myths in the
Evaluation and Management of Ovarian Torsion".
269:
1816:
1345:
315:
300:
239:, but these do not completely rule out the diagnosis. Surgery is the most accurate method of diagnosis.
1811:
1544:
1241:
289:
1860:
1429:
323:
319:
292:
department found that preoperative diagnosis of ovarian torsion was confirmed in only 46% of people.
1377:
1196:
1014:
1744:
1694:
1650:
1308:
71:
1722:
1298:
1137:
1097:
132:
39:
589:
1727:
1581:
1524:
1449:
1387:
1248:
1066:
565:
1739:
1164:
8:
1850:
1789:
1645:
1054:
1003:
647:
224:
1717:
1674:
1640:
1576:
1539:
1444:
1335:
1236:
1191:
1147:
1142:
953:
797:
411:
311:
304:
59:
1008:
748:
731:
1732:
1630:
1313:
1201:
1025:
945:
910:
875:
820:
789:
785:
753:
686:
682:
627:
595:
553:
513:
149:
115:
47:
1019:
957:
801:
326:
of 78% and 71%, respectively. Specific flow features on
Doppler sonography include:
1855:
1784:
1586:
1414:
1181:
1120:
937:
902:
867:
781:
770:
743:
678:
545:
509:
505:
355:
141:
710:
549:
1662:
1605:
1514:
1478:
1419:
1360:
1129:
330:
Little or no intra-ovarian venous flow. This is commonly seen in ovarian torsion.
189:
536:
Asfour V, Varma R, Menon P (2015). "Clinical risk factors for ovarian torsion".
1837:
1699:
1591:
1551:
1529:
1365:
1228:
1213:
1157:
1030:
941:
871:
228:
216:
108:
100:
993:
389:
of the ovary can occur. In these cases the ovary must be surgically removed.
1894:
1845:
1370:
1355:
1318:
1253:
1171:
399:
212:
145:
96:
1764:
1617:
1496:
1404:
1382:
1323:
1258:
1186:
1101:
949:
914:
906:
879:
793:
757:
690:
557:
517:
348:
137:
1769:
1684:
1657:
1621:
1567:
1488:
1473:
1399:
1286:
1263:
1152:
715:
382:
277:
205:
193:
91:
76:
64:
840:
1870:
1754:
1704:
1626:
1534:
1465:
1350:
1176:
273:
268:
the fallopian tube as well on their shared vascular pedicle around the
121:
52:
976:
732:"Usefulness of Doppler sonography in the diagnosis of ovarian torsion"
333:
Absent arterial flow. This is a less common finding in ovarian torsion
1759:
1749:
1635:
1105:
1049:
652:
220:
201:
104:
1865:
1571:
386:
256:
236:
125:
192:, such that blood flow is decreased. Symptoms typically include
1506:
1277:
988:
318:
of abnormal ovarian flow are 44% and 92%, respectively, with a
252:
197:
1096:
668:
360:
Free pelvic fluid. This may be seen in more than 80% of cases
185:
857:
624:
Rosen's
Emergency Medicine: Concepts and Clinical Practice
372:
Uterus may be slightly deviated towards the torted ovary.
272:, although in rare cases the ovary rotates around the
16:
Twisting of an ovary such that blood flow is decreased
729:
591:
CT and MRI of the
Abdomen and Pelvis: A Teaching File
966:
495:
930:
International
Journal of Gynaecology and Obstetrics
892:
774:The Journal of Obstetrics and Gynaecology Research
730:Peña JE, Ufberg D, Cooney N, Denis AL (May 2000).
594:. Lippincott Williams & Wilkins. p. 395.
1901:Noninflammatory disorders of female genital tract
570:: CS1 maint: DOI inactive as of September 2024 (
1892:
535:
381:Surgical treatment of ovarian torsion includes
927:
860:Journal of Pediatric and Adolescent Gynecology
1082:
704:
702:
700:
764:
433:
431:
429:
427:
369:Underlying ovarian lesion can often be found
723:
708:
1089:
1075:
814:
697:
587:
491:
489:
487:
485:
483:
481:
479:
303:is the imaging modality of choice. Use of
38:
819:. McGraw Hill Professional. p. 904.
747:
617:
615:
613:
611:
583:
581:
477:
475:
473:
471:
469:
467:
465:
463:
461:
459:
424:
343:Other ultrasonographic features include:
276:or the fallopian tube rotates around the
664:
662:
660:
531:
529:
527:
231:. The diagnosis may be supported by an
1893:
626:(9 ed.). Elsevier. p. 1232.
608:
578:
456:
1119:
1070:
657:
538:Journal of Obstetrics and Gynaecology
524:
246:
621:
1876:Persistent genital arousal disorder
13:
443:Merck Manuals Professional Edition
262:
184:is an abnormal condition where an
14:
1912:
1690:Hypoactive sexual desire disorder
1209:Ovarian hyperstimulation syndrome
498:The Journal of Emergency Medicine
336:Absent or reversed diastolic flow
786:10.1111/j.1447-0756.2008.00768.x
683:10.1016/j.fertnstert.2008.12.022
921:
886:
851:
833:
808:
414:– equivalent condition in males
392:
349:hypoechogenic or hyperechogenic
1304:Dysfunctional uterine bleeding
640:
510:10.1016/j.jemermed.2016.11.012
310:Lack of ovarian blood flow on
233:ultrasound done via the vagina
190:attachment to other structures
1:
749:10.1016/S0015-0282(00)00487-8
550:10.3109/01443615.2015.1004524
418:
295:
1400:Menorrhagia (hypermenorrhea)
1371:Polymenorrhea (epimenorrhea)
895:Journal of Pediatric Surgery
376:
283:
200:. Complications may include
167:6 per 100,000 women per year
7:
1817:Pelvic inflammatory disease
588:Ros PR, Mortele KJ (2007).
405:
366:of twisted vascular pedicle
316:sensitivity and specificity
301:Gynecologic ultrasonography
10:
1917:
1812:Pelvic congestion syndrome
1242:Fallopian tube obstruction
942:10.1016/j.ijgo.2014.11.027
872:10.1016/j.jpag.2003.09.017
290:obstetrics and gynaecology
1861:Vestibular papillomatosis
1836:
1829:
1804:
1780:
1713:
1671:
1613:
1604:
1560:
1505:
1487:
1464:
1440:
1430:Metropathia haemorrhagica
1332:
1294:
1285:
1276:
1227:
1128:
1112:
1040:
970:
324:negative predictive value
163:
155:
131:
114:
90:
82:
70:
58:
46:
37:
29:
24:
1197:Follicular cyst of ovary
1695:Sexual arousal disorder
1651:Candidal vulvovaginitis
1309:Endometrial hyperplasia
736:Fertility and Sterility
709:Weerakkody Y, Dixon A.
671:Fertility and Sterility
552:(inactive 2024-09-13).
354:Peripherally displaced
215:, ovarian enlargement,
99:, ovarian enlargement,
1138:Endometriosis of ovary
907:10.1053/jpsu.2000.8764
133:Differential diagnosis
1582:Vesicouterine fistula
1525:Cervical incompetence
1450:Recurrent miscarriage
1388:Premenstrual syndrome
1249:Fallopian tube cancer
815:Tintinalli J (2004).
211:Risk factors include
1740:Rectovaginal fistula
1165:Poor ovarian reserve
1790:Postcoital bleeding
1718:Urogenital fistulas
1646:Bacterial vaginosis
1299:Asherman's syndrome
225:fertility treatment
120:Based on symptoms,
1675:Sexual dysfunction
1641:Atrophic vaginitis
1577:Retroverted uterus
1540:Female infertility
1520:Cervical dysplasia
1445:Female infertility
1237:Female infertility
1192:Corpus luteum cyst
1148:Ovulatory disorder
1143:Female infertility
1041:External resources
817:Emergency Medicine
412:Testicular torsion
312:doppler sonography
305:doppler ultrasound
247:Signs and symptoms
86:Classically sudden
1888:
1887:
1884:
1883:
1825:
1824:
1800:
1799:
1733:Obstetric fistula
1631:Vaginal discharge
1600:
1599:
1545:Cervical stenosis
1460:
1459:
1314:Endometrial polyp
1272:
1271:
1202:Theca lutein cyst
1064:
1063:
826:978-0-07-138875-7
711:"Ovarian torsion"
439:"Adnexal Torsion"
356:ovarian follicles
171:
170:
150:ectopic pregnancy
116:Diagnostic method
19:Medical condition
1908:
1856:Kraurosis vulvae
1851:Bartholin's cyst
1834:
1833:
1785:Vaginal bleeding
1678:
1611:
1610:
1587:Uterine prolapse
1415:Menometrorrhagia
1339:
1292:
1291:
1283:
1282:
1182:Ovarian apoplexy
1126:
1125:
1117:
1116:
1091:
1084:
1077:
1068:
1067:
968:
967:
962:
961:
925:
919:
918:
890:
884:
883:
855:
849:
848:
837:
831:
830:
812:
806:
805:
768:
762:
761:
751:
727:
721:
720:
706:
695:
694:
666:
655:
644:
638:
637:
619:
606:
605:
585:
576:
575:
569:
561:
533:
522:
521:
493:
454:
453:
451:
449:
435:
142:kidney infection
42:
22:
21:
1916:
1915:
1911:
1910:
1909:
1907:
1906:
1905:
1891:
1890:
1889:
1880:
1821:
1796:
1776:
1709:
1672:
1667:
1663:Vaginal atresia
1596:
1556:
1515:Cervical cancer
1501:
1483:
1479:Uterine fibroid
1456:
1436:
1420:Polymenorrhagia
1361:Oligoamenorrhea
1333:
1328:
1268:
1223:
1219:Ovarian torsion
1108:
1098:Female diseases
1095:
1065:
1060:
1059:
1036:
1035:
979:
965:
926:
922:
891:
887:
856:
852:
839:
838:
834:
827:
813:
809:
769:
765:
728:
724:
707:
698:
667:
658:
648:Ovarian Torsion
645:
641:
634:
622:Wall R (2017).
620:
609:
602:
586:
579:
563:
562:
534:
525:
494:
457:
447:
445:
437:
436:
425:
421:
408:
395:
379:
298:
286:
265:
263:Pathophysiology
249:
204:, bleeding, or
182:adnexal torsion
174:Ovarian torsion
33:Adnexal torsion
25:Ovarian torsion
20:
17:
12:
11:
5:
1914:
1904:
1903:
1886:
1885:
1882:
1881:
1879:
1878:
1873:
1868:
1863:
1858:
1853:
1848:
1842:
1840:
1831:
1827:
1826:
1823:
1822:
1820:
1819:
1814:
1808:
1806:
1802:
1801:
1798:
1797:
1795:
1794:
1793:
1792:
1781:
1778:
1777:
1775:
1774:
1773:
1772:
1767:
1762:
1757:
1752:
1742:
1737:
1736:
1735:
1730:
1725:
1723:Ureterovaginal
1714:
1711:
1710:
1708:
1707:
1702:
1700:Vaginal cancer
1697:
1692:
1687:
1681:
1679:
1669:
1668:
1666:
1665:
1660:
1655:
1654:
1653:
1648:
1643:
1633:
1624:
1614:
1608:
1602:
1601:
1598:
1597:
1595:
1594:
1592:Uterine cancer
1589:
1584:
1579:
1574:
1564:
1562:
1558:
1557:
1555:
1554:
1552:Nabothian cyst
1549:
1548:
1547:
1537:
1532:
1530:Cervical polyp
1527:
1522:
1517:
1511:
1509:
1503:
1502:
1500:
1499:
1493:
1491:
1485:
1484:
1482:
1481:
1476:
1470:
1468:
1462:
1461:
1458:
1457:
1455:
1454:
1453:
1452:
1441:
1438:
1437:
1435:
1434:
1433:
1432:
1424:
1423:
1422:
1417:
1409:
1408:
1407:
1402:
1392:
1391:
1390:
1385:
1375:
1374:
1373:
1368:
1366:Oligomenorrhea
1363:
1358:
1353:
1342:
1340:
1330:
1329:
1327:
1326:
1321:
1316:
1311:
1306:
1301:
1295:
1289:
1280:
1274:
1273:
1270:
1269:
1267:
1266:
1261:
1256:
1251:
1246:
1245:
1244:
1233:
1231:
1229:Fallopian tube
1225:
1224:
1222:
1221:
1216:
1214:Ovarian cancer
1211:
1206:
1205:
1204:
1199:
1194:
1184:
1179:
1174:
1169:
1168:
1167:
1162:
1161:
1160:
1158:Oligoovulation
1155:
1140:
1134:
1132:
1123:
1114:
1110:
1109:
1094:
1093:
1086:
1079:
1071:
1062:
1061:
1058:
1057:
1055:article/795994
1045:
1044:
1042:
1038:
1037:
1034:
1033:
1022:
1011:
996:
980:
975:
974:
972:
971:Classification
964:
963:
920:
901:(8): 1248–51.
885:
850:
832:
825:
807:
763:
742:(5): 1047–50.
722:
696:
656:
639:
633:978-0323354790
632:
607:
600:
577:
523:
504:(4): 449–456.
455:
422:
420:
417:
416:
415:
407:
404:
402:in pregnancy.
394:
391:
378:
375:
374:
373:
370:
367:
364:Whirlpool sign
361:
358:
352:
338:
337:
334:
331:
297:
294:
285:
282:
270:broad ligament
264:
261:
248:
245:
229:tubal ligation
217:ovarian tumors
188:twists on its
169:
168:
165:
161:
160:
157:
153:
152:
135:
129:
128:
118:
112:
111:
109:tubal ligation
101:ovarian tumors
94:
88:
87:
84:
80:
79:
74:
68:
67:
62:
56:
55:
50:
44:
43:
35:
34:
31:
27:
26:
18:
15:
9:
6:
4:
3:
2:
1913:
1902:
1899:
1898:
1896:
1877:
1874:
1872:
1869:
1867:
1864:
1862:
1859:
1857:
1854:
1852:
1849:
1847:
1846:Vulvar cancer
1844:
1843:
1841:
1839:
1835:
1832:
1828:
1818:
1815:
1813:
1810:
1809:
1807:
1803:
1791:
1788:
1787:
1786:
1783:
1782:
1779:
1771:
1768:
1766:
1763:
1761:
1758:
1756:
1753:
1751:
1748:
1747:
1746:
1743:
1741:
1738:
1734:
1731:
1729:
1728:Vesicovaginal
1726:
1724:
1721:
1720:
1719:
1716:
1715:
1712:
1706:
1703:
1701:
1698:
1696:
1693:
1691:
1688:
1686:
1683:
1682:
1680:
1677:
1676:
1670:
1664:
1661:
1659:
1656:
1652:
1649:
1647:
1644:
1642:
1639:
1638:
1637:
1634:
1632:
1628:
1625:
1623:
1619:
1616:
1615:
1612:
1609:
1607:
1603:
1593:
1590:
1588:
1585:
1583:
1580:
1578:
1575:
1573:
1569:
1566:
1565:
1563:
1559:
1553:
1550:
1546:
1543:
1542:
1541:
1538:
1536:
1533:
1531:
1528:
1526:
1523:
1521:
1518:
1516:
1513:
1512:
1510:
1508:
1504:
1498:
1495:
1494:
1492:
1490:
1486:
1480:
1477:
1475:
1472:
1471:
1469:
1467:
1463:
1451:
1448:
1447:
1446:
1443:
1442:
1439:
1431:
1428:
1427:
1425:
1421:
1418:
1416:
1413:
1412:
1410:
1406:
1403:
1401:
1398:
1397:
1396:
1393:
1389:
1386:
1384:
1381:
1380:
1379:
1376:
1372:
1369:
1367:
1364:
1362:
1359:
1357:
1356:Hypomenorrhea
1354:
1352:
1349:
1348:
1347:
1344:
1343:
1341:
1338:
1337:
1331:
1325:
1322:
1320:
1319:Endometriosis
1317:
1315:
1312:
1310:
1307:
1305:
1302:
1300:
1297:
1296:
1293:
1290:
1288:
1284:
1281:
1279:
1275:
1265:
1262:
1260:
1257:
1255:
1254:Hematosalpinx
1252:
1250:
1247:
1243:
1240:
1239:
1238:
1235:
1234:
1232:
1230:
1226:
1220:
1217:
1215:
1212:
1210:
1207:
1203:
1200:
1198:
1195:
1193:
1190:
1189:
1188:
1185:
1183:
1180:
1178:
1175:
1173:
1172:Mittelschmerz
1170:
1166:
1163:
1159:
1156:
1154:
1151:
1150:
1149:
1146:
1145:
1144:
1141:
1139:
1136:
1135:
1133:
1131:
1127:
1124:
1122:
1118:
1115:
1111:
1107:
1103:
1099:
1092:
1087:
1085:
1080:
1078:
1073:
1072:
1069:
1056:
1052:
1051:
1047:
1046:
1043:
1039:
1032:
1028:
1027:
1023:
1021:
1017:
1016:
1012:
1010:
1006:
1005:
1001:
997:
995:
991:
990:
986:
982:
981:
978:
973:
969:
959:
955:
951:
947:
943:
939:
936:(2): 169–70.
935:
931:
924:
916:
912:
908:
904:
900:
896:
889:
881:
877:
873:
869:
865:
861:
854:
846:
842:
841:"oophoropexy"
836:
828:
822:
818:
811:
803:
799:
795:
791:
787:
783:
780:(2): 266–70.
779:
775:
767:
759:
755:
750:
745:
741:
737:
733:
726:
718:
717:
712:
705:
703:
701:
692:
688:
684:
680:
677:(6): 2012–5.
676:
672:
665:
663:
661:
654:
650:
649:
643:
635:
629:
625:
618:
616:
614:
612:
603:
601:9780781772372
597:
593:
592:
584:
582:
573:
567:
559:
555:
551:
547:
543:
539:
532:
530:
528:
519:
515:
511:
507:
503:
499:
492:
490:
488:
486:
484:
482:
480:
478:
476:
474:
472:
470:
468:
466:
464:
462:
460:
444:
440:
434:
432:
430:
428:
423:
413:
410:
409:
403:
401:
400:corpus luteum
390:
388:
384:
371:
368:
365:
362:
359:
357:
353:
350:
346:
345:
344:
341:
335:
332:
329:
328:
327:
325:
321:
317:
313:
308:
306:
302:
293:
291:
281:
279:
275:
271:
260:
258:
254:
244:
240:
238:
234:
230:
226:
222:
218:
214:
213:ovarian cysts
209:
207:
203:
199:
195:
191:
187:
183:
179:
175:
166:
162:
158:
154:
151:
147:
146:kidney stones
143:
139:
136:
134:
130:
127:
123:
119:
117:
113:
110:
106:
102:
98:
97:Ovarian cysts
95:
93:
89:
85:
81:
78:
75:
73:
72:Complications
69:
66:
63:
61:
57:
54:
51:
49:
45:
41:
36:
32:
28:
23:
1765:Sigmoidocele
1673:
1618:Hematocolpos
1497:Parametritis
1405:Metrorrhagia
1383:Dysmenorrhea
1336:Menstruation
1334:
1324:Endometritis
1259:Hydrosalpinx
1218:
1187:Ovarian cyst
1048:
1024:
1013:
998:
983:
933:
929:
923:
898:
894:
888:
866:(6): 381–4.
863:
859:
853:
844:
835:
816:
810:
777:
773:
766:
739:
735:
725:
714:
674:
670:
646:
642:
623:
590:
566:cite journal
544:(7): 721–5.
541:
537:
501:
497:
448:12 September
446:. Retrieved
442:
396:
393:Epidemiology
380:
363:
342:
339:
309:
299:
287:
266:
250:
241:
227:, and prior
210:
181:
177:
173:
172:
138:Appendicitis
92:Risk factors
1770:Urethrocele
1685:Dyspareunia
1658:Hydrocolpos
1622:Hydrocolpos
1568:Hematometra
1489:Parametrium
1474:Adenomyosis
1287:Endometrium
1264:Salpingitis
1153:Anovulation
716:Radiopaedia
383:laparoscopy
278:mesosalpinx
206:infertility
194:pelvic pain
83:Usual onset
77:Infertility
65:Pelvic pain
30:Other names
1871:Vulvodynia
1755:Enterocele
1705:Vaginismus
1627:Leukorrhea
1535:Cervicitis
1466:Myometrium
1351:Amenorrhea
1177:Oophoritis
1026:DiseasesDB
1020:D000082843
845:Repropedia
419:References
296:Ultrasound
274:mesovarium
122:ultrasound
53:Gynecology
1760:Rectocele
1750:Cystocele
1636:Vaginitis
1050:eMedicine
653:eMedicine
377:Treatment
347:Enlarged
284:Diagnosis
221:pregnancy
202:infection
164:Frequency
156:Treatment
105:pregnancy
48:Specialty
1895:Category
1866:Vulvitis
1830:External
1745:Prolapse
1572:Pyometra
1113:Internal
1106:genitals
958:12427870
950:25721499
915:10945705
880:14642961
802:25469572
794:18412795
758:10785237
691:19159873
558:26212687
518:27988260
406:See also
387:necrosis
320:positive
257:vomiting
60:Symptoms
1561:General
1100:of the
237:CT scan
159:Surgery
126:CT scan
1606:Vagina
1507:Cervix
1426:Other
1411:Mixed
1395:Timing
1278:Uterus
1121:Adnexa
1102:pelvis
956:
948:
913:
878:
823:
800:
792:
756:
689:
630:
598:
556:
516:
253:nausea
198:nausea
1838:Vulva
1805:Other
1130:Ovary
1031:31120
1009:620.5
994:N83.5
954:S2CID
798:S2CID
351:ovary
186:ovary
180:) or
1378:Pain
1346:Flow
1104:and
1015:MeSH
1004:9-CM
946:PMID
911:PMID
876:PMID
821:ISBN
790:PMID
754:PMID
687:PMID
628:ISBN
596:ISBN
572:link
554:PMID
514:PMID
450:2018
322:and
255:and
1000:ICD
985:ICD
938:doi
934:129
903:doi
868:doi
782:doi
744:doi
679:doi
651:at
546:doi
506:doi
235:or
1897::
1629:/
1620:/
1570:/
1053::
1029::
1018::
1007::
992::
989:10
952:.
944:.
932:.
909:.
899:35
897:.
874:.
864:16
862:.
843:.
796:.
788:.
778:34
776:.
752:.
740:73
738:.
734:.
713:.
699:^
685:.
675:93
673:.
659:^
610:^
580:^
568:}}
564:{{
542:35
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526:^
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458:^
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223:,
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178:OT
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1002:-
987:-
977:D
960:.
940::
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882:.
870::
847:.
829:.
804:.
784::
760:.
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693:.
681::
636:.
604:.
574:)
560:.
548::
520:.
508::
452:.
176:(
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