Ovarian remnant syndrome

Abstract

Objective To review different diagnostic and surgical procedures for ovarian remnant syndrome and suggest that complete primary resection is the only method to avoid recurrence. Data sources Sources include original articles and reviews on various ovarian remnant surgical techniques, on comparisons of laparotomy with laparoscopy and on the employment of possible medical methods for treatment, and reviews of methods and techniques for diagnosing ovarian remnant syndrome. The technical sources dated from 1953 to the present. Methods of study selection Studies of methods and follow up of ovarian remnant techniques currently used. Review articles including surgical and medical techniques with long‐term outcomes and patient selection criteria were utilized to formulate a strategy for appropriate selection of ovarian remnant removal. Data extraction and synthesis The methods reviewed include clinically applied surgical and medical techniques. Articles including surgical and nonsurgical treatment for ‘remnant removal’ were utilized with a review of laparotomy and laparoscopy data. Conclusions Complete excision of ovarian remnants via exploratory laparotomy affords patients the best option for avoiding future corrective surgery for pelvic pain from persistent ovarian remnants.

The effect of hysterectomy on ovarian blood supply and endocrine function

“…Thirteen (26%) patients and 15 (30%) patients had ovarian cysts 1 and 3 months after hysterectomy, the prevalence of which is consistent with the previous studies 25, 28 . The most common histopathologic findings are functional cysts (in more than 50% of cases) of unknown physiopathologic nature; these cysts frequently appear within the first postoperative year and, in most cases, spontaneously resolve 12,25,28 .…”

“…The most common histopathologic findings are functional cysts (in more than 50% of cases) of unknown physiopathologic nature; these cysts frequently appear within the first postoperative year and, in most cases, spontaneously resolve 12,25,28 . As shown in this study, nine cysts (69.2%) disappeared after 2 months follow-up.…”

Mucinous adenocarcinoma in an ovarian remnant

“…Ovarian remnants occur after a portion of ovarian tissue is left intact following oophorectomy, particularly during a difficult oophorectomy. Hormonally active remnants manifest with variable presentations including pelvic pain, flank pain, dyspareunia, hydronephrosis due to ureteral compression, bowel obstruction, and a palpable, tender pelvic mass (2,3,5) . Symptoms commonly present within 5 years of extirpative surgery (12) .…”

“…Furthermore, complete surgical excision is the only effective therapy to avoid recurrence of symptoms (5) . Cytologic or histologic diagnosis of benign ovarian tissue established in the preoperative setting can help determine the proper surgical approach.…”

“…As evidenced by our patient, ovarian remnant syndrome can occur after abdominal or vaginal hysterectomy and bilateral salpingo-oophorectomy. Prevention of ovarian remnant syndrome with complete resection of ovarian tissue and surrounding peritoneum at the time of oophorectomy is crucial, and most support excision of ovarian remnants via exploratory laparotomy as the best alternative to avoid recurrence of symptoms (5) . However, in our institution, we adopted and maintain a laparoscopic approach in such patients.…”