title: The residual ovary syndrome: a 20-year experience.
abstract: OBJECTIVE
  To address the controversy of ovarian preservation during a hysterectomy for benign indications by using our experience with residual ovary syndrome (ROS).
  
  
  METHODS
  Over a period of 20 years, 2561 hysterectomies (during which one or both ovaries were preserved) were performed at the Golda Medical Center, Israel. A retrospective, quasi, case-control analysis was undertaken.
  
  
  RESULTS
  The incidence of ROS was 2.85%. While chronic pelvic pain was the principle indication for subsequent reexploration in 52 patients (71.3%), an asymptomatic pelvic mass noted during routine follow-up examination accounted for 24.6% of operations for ROS. The majority (75.4%) of patients underwent surgery during the first 10 years, while the highest incidence occurred within the first 5 years (46.6%). Furthermore, histological examination revealed functional cysts, benign neoplasm and ovarian carcinoma in 50.7%, 42.6% and 12.3% of the cases, respectively (in nine patients more than one pathology was observed).
  
  
  CONCLUSIONS
  Since ROS was found to occur in 1/35 women who had undergone previous hysterectomies mainly due to physiologic ovarian function and benign cyst formation, but not malignancy, we believe that routine oophorectomy is justified in premenopausal women over 45 years of age. However, the final decision to perform elective oophorectomy at the time of hysterectomy for benign disease should be established on an individual basis, taking into consideration age, individual and family risk factors, the patient's preference and ability to ensure long-term compliance to exogenous hormone replacement therapy.
authors.affiliation: Department of Obstetrics and Gynecology, Rabin Medical Center, Hasharon Hospital, Petah Tiqva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Dekel
authors.forename: Z
authors.initials: Z
authors.lastname: Efrat
authors.forename: R
authors.initials: R
authors.lastname: Orvieto
authors.forename: T
authors.initials: T
authors.lastname: Levy
authors.forename: D
authors.initials: D
authors.lastname: Dicker
authors.forename: R
authors.initials: R
authors.lastname: Gal
authors.forename: Z
authors.initials: Z
authors.lastname: Ben-Rafael
mesh_terms: D000328:Adult; D017558:Elective Surgical Procedures; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010049:Ovarian Diseases / Q000517:prevention & control*; D010052:Ovariectomy; D010349:Patient Compliance; D017699:Pelvic Pain; D012307:Risk Factors; D013577:Syndrome