Adequacy of laparoscopic oophorectomy

Ovarian remnant syndrome occurs infrequently after oophorectomy, yet when present it can contribute greatly to pelvic discomfort. The syndrome may be difficult to diagnose, identify surgically, and treat without intraoperative or postoperative complications developing. Recently, laparoscopic oophorectomy has been performed with increasing frequency. We assessed the outcome after laparoscopic removal of both ovaries or the sole remaining ovary in 27 premenopausal women. No intraoperative or postoperative complications were identified, and no patients have experienced symptoms consistent with ovarian remnant syndrome. All women had a marked rise in serum follicle-stimulating hormone (FSH) levels (81 to 72+/-5 mIU/ml), and luteinizing hormone (LH) levels (8+/-1 to 37+/-3 mIU/ml) after oophorectomy, and all but one had FSH levels 40 mIU/ml or above. Thirteen women had gonadotropin levels measured after 4 weeks of hormone replacement therapy; all had reductions in FSH levels, but 10 had elevations of their LH levels. These findings indicate that ovarian remnant syndrome occurs infrequently after laparoscopic oophorectomy. In addition, the data suggest a different, nonovarian regulation of gonadotropin secretion.