The residual ovary syndrome

Previous reports have demonstrated a significant incidence of pelvic symptomatology involving ovaries preserved following hysterectomy, to be called "the residual ovary syndrome." This report, in an 11-year retrospective analysis of all oophorectomies at The Methodist Hospital in Houston, Texas, identified 202 cases in which a previous hysterectomy had been performed. The majority of these patients presented with varying degrees of chronic pelvic pain (77.2%), asymptomatic pelvic mass (14.4%), and dyspareunia (67.0%). The incidence of malignant neoplastic change in these patients was 3.0%, related to whether hysterectomy was performed before or after the age of 40. In view of the incidence of the residual ovary syndrome and the risk of malignant neoplastic change when hysterectomy is performed after the age of 40, serious consideration of total ovarian ablation at the time of hysterectomy should be weighed against any temporary physiologic and/or psychologic benefits to be gained from conservation.