Ellie's story: the importance of expert intervention for ovarian torsion

When Ellie, aged 33, began experiencing cramping during a weekend away, she assumed it was bad period pain. But when the pain intensified, Ellie knew that there was something wrong, so her and her fiancé John went to A&E. Unable to definitively diagnose the cause of the pain, the team in A&E thought it was most likely a burst cyst. Ellie was prescribed some painkillers and sent home. 

Unbeknown to the medical team in A&E, Ellie was experiencing ovarian torsion, a serious and notoriously difficult to diagnose condition, that causes the ovary to twist. The ovaries are two small organs that form part of the female reproductive system, they have two main functions; to produce reproductive hormones, and to release an egg each month, ready for fertilisation. Ovarian torsion usually occurs when a cyst on the ovary causes the tissue, or surrounding structures, to twist. This can cut off the blood supply to the ovary, causing tissue damage and potentially impacting fertility.

The importance of expert intervention

Back home in London Ellie continued to experience pain, and her symptoms intensified, so much so, that she was unable to sleep and felt intensely nauseous from the increasing pain. That’s when Ellie and John turned to HCA Healthcare UK The Wellington Hospital's Urgent Care Centre. Ultrasound scans did not immediately indicate an ovarian torsion, but based on Ellie’s symptoms the team felt this could still be a possibility, so they called on expert consultant gynaecologist, Mr Osama Naji.

Mr Naji reviewed Ellie’s scan results and called on a colleague for a second opinion. Together, they concluded, that there was a strong chance Ellie had an ovarian torsion. Therefore, Mr Naji felt the best action would be a further examination and an MRI scan. He discussed this with Ellie, reassuring her, and made arrangements for an urgent scan to take place.

“He explained they were going to get a team together,” Ellie recalls. “The level of expertise and communication I received from him was incredible. He was unbelievable, I have never come across another doctor who is quite so caring. After the MRI scan Mr Naji explained that, while it couldn’t be 100% confirmed from the scans alone, he did feel ovarian torsion was the correct diagnosis. This meant I needed to be operated on immediately, and he explained there was an 80% chance of saving my ovary if we went ahead with surgery right away.”

The team arranged for Ellie to be transferred to HCA Healthcare UK The Princess Grace Hospital, where Mr Naji and the theatre team were ready to operate. 

Time critical surgery

At around 10pm that evening, just an hour after Mr Naji’s decision to operate, Ellie underwent surgery. Mr Naji performed a laparoscopy, a type of minimally invasive surgery - often referred to a keyhole surgery, which is used to diagnose and treat conditions. During the procedure a thin flexible tube with a tiny video camera, was passed through a small incision in Ellie’s abdomen, to check her ovaries. 

As suspected an ovarian torsion was found. In Ellie’s case there was no cyst causing the torsion, known as a spontaneous torsion, a very rare condition that can be even harder to diagnose. Mr Naji discovered that the tissue connected to Ellie’s ovary had, in fact, twisted twice, he was able to release the ovary which was only mildly enlarged.

“When I came round from the anaesthetic, Mr Naji explained the procedure had gone well, they had saved my ovary. The pain was gone, it felt like a miracle. I had never experienced persistence like Mr Naji’s. He said if we had waited another three hours the tissue could have been permanently damaged, and the function of my ovary potentially lost.”

“Everything happened so quickly, and the communication between the hospitals was seamless. Everyone was always updating me, they arranged transport, and despite how fraught I was feeling, it felt very smooth. Mr Naji was really warm, he’s a very knowledgeable doctor, but also a person who truly cares.”

Ellie returned home the next day and Mr Naji called to check how she was feeling, and he arranged a follow-up appointment for the next week. Since then Ellie has had a series of scans to monitor her ovaries, all scans have been reassuringly normal, and no further treatment is planned.

Ellie’s fiancé receives an unexpected diagnosis

Just six months later, while visiting family in Greece, Ellie’s fiancé John received an unexpected diagnosis of testicular cancer. Needing to arrange urgent treatment in the UK, the couple once again called on Mr Naji for his advice.

“Mr Naji instilled so much trust in both of us when he cared for me, so I immediately telephoned him. He reassured us from the beginning. He told us to get all our reports translated and arranged an appointment for us with one of his colleagues, Mr Arun Sahai, a consultant urologist. He spoke to him to ensure he could take on our case, and personally made sure everything was in place.”

A network of expertise 

Within a week, John was back in the UK and met with Mr Sahai at HCA Healthcare UK London Bridge Hospital. John had surgery just a few days later to remove his testicular tumour, the next step was to meet with an oncologist to discuss chemotherapy treatment. 

“We stayed in touch with Mr Naji during John’s treatment, and were incredibly thankful for his guidance. As this next step of John’s treatment was discussed, I once again reached out to Mr Naji with concerns about our plans to have a family in the future. John was able to bank his sperm before starting chemotherapy, in case his treatment impacted his fertility, and I had considered freezing my eggs for the future. However, after discussing this with Mr Naji he really reassured me that this was not something I needed to rush into. That we could wait for John to complete his treatment, and after a period of time we could try for a baby. If this was unsuccessful, then we could seek further guidance on our fertility options. I found this very reassuring.”

Thankfully John has now been given the ‘all clear’, based on his treatment the medical team have recommended waiting a year before trying to start a family. In the meantime, the couple plan to focus on getting married later this year, after delaying their wedding, due to a difficult year with their health. They have even invited Mr Naji and his wife Lena to join them on their big day.

Ellie and John believe the integrated approach across the HCA Healthcare UK network, and Mr Naji’s excellent care, has helped them to navigate this challenging time. “The hospitals have worked so smoothly together to look after us, and Mr Naji has helped us both, he is our trusted advisor.”, says Ellie. If difficulties arise again, we feel held. This is a team of serious doctors, working together, and always trying to meet your needs. You can see they are trying their very best and genuinely care for their patients.”