Ovarian remnant syndrome

Area of Science:

• Gynecology
• Reproductive Medicine
• Surgical Oncology

Background:

• Ovarian remnant syndrome (ORS) is a condition where residual ovarian tissue persists after bilateral salpingo-oophorectomy.
• ORS can lead to symptoms such as pelvic pain and masses, often due to associated endometriosis or functional cysts.
• Surgical management aims for complete excision of remnant tissue while minimizing complications.

Purpose of the Study:

• To evaluate the surgical management and outcomes of patients diagnosed with ovarian remnant syndrome.
• To assess the complication rates, recurrence rates, and symptom resolution following surgical intervention for ORS.

Main Methods:

• Retrospective review of 186 patients treated surgically for ORS between 1985 and 2003.
• Data abstracted included patient demographics, surgical approach (laparotomy, laparoscopy, transvaginal), presenting symptoms, and pathological findings.
• Follow-up included a mailed questionnaire to assess long-term outcomes and recurrence.

Main Results:

• The majority of patients (85%) underwent oophorectomy via laparotomy.
• Common presenting symptoms were pelvic masses (57%) and pelvic pain (48%).
• The intraoperative complication rate was 9.6%, with 9% of patients requiring re-exploration. Remnant ovarian tissue was associated with corpus luteum (42%) and endometriosis (29%).

Conclusions:

• Definitive surgical treatment for ORS carries a modest risk of injury to adjacent organs but results in minimal recurrence (<1%).
• Over 90% of patients experienced resolution or significant improvement in their symptoms post-surgery.
• Surgical excision, including pelvic sidewall stripping and apical vaginal excision, is effective in managing ORS with favorable long-term outcomes.