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Frequency and laparoscopic management of ovarian remnant syndrome
Basim Abu-Rafeh1, George A Vilos, Millie Misra
1Department of Obstetrics and Gynecology, University of Western Ontario, London, Ontario N6A 4V2, Canada.
Study Objective:
To report the frequency and outcome of laparoscopy in women with chronic pelvic pain and/or pelvic mass who were found to have ovarian remnants.
Design:
Cohort study. (Canadian Task Force classification II-2).
Setting:
University-affiliated hospital.
Patients:
One hundred nineteen women who had had hysterectomy and oophorectomy.
Intervention:
Laparoscopic surgery.
Measurements And Main Results:
Ovarian remnants were known in 5 and were found intraoperatively in 21 patients (18%). These 26 women had undergone at least one laparoscopy in an attempt to remove the remnants. After the ureter was identified, ovarian remnants were dissected and removed from the retroperitoneum laparoscopically with minimal risk of vessel or visceral injury. There were no intraoperative or postoperative complications and no conversions to laparotomy. In addition to ovarian remnants, adhesions were found in 19 women, endometriosis in 4, and no other pathology in 3. Twenty women had complete relief of symptoms. At follow-up of 1 to 8 years (mean 5 yrs), six underwent repeat laparoscopy for persistent pain; one had recurrent ovarian remnant.
Conclusions:
Ovarian remnant syndrome is not an infrequent complication after hysterectomy and oophorectomy in women with endometriosis.