Ovarian remnant syndrome.
OBJECTIVE
This study was undertaken to examine surgical management of patients with ovarian remnant syndrome.


METHODS
Data were abstracted from records of patients with a history of bilateral salpingo-oophorectomy who were treated surgically at Mayo Clinic between 1985 and 2003 for pathologically confirmed residual ovarian tissue. A follow-up questionnaire was also mailed.


RESULTS
Records review identified 186 patients (mean age, 37.6 years; mean follow-up, 1.2 years). Of 180 patients with available data, 153 (85%) underwent oophorectomy by laparotomy, 13 (7%) by laparoscopy, and 14 (8%) by transvaginal approach, mostly for endometriosis (56.8%). Of 186 patients, 105 (57%) presented with pelvic masses and 89 (48%) with pelvic pain. Remnant ovarian tissue was associated with a corpus luteum in 78 (42%) and endometriosis in 54 (29%). The intraoperative complication rate was 9.6%. Of 142 patients, 12 (9%) required subsequent re-exploration (1 ovarian remnant identified).


CONCLUSIONS
This heavily pretreated population has modest risk of bowel, bladder, or ureteral trauma with definitive pelvic sidewall stripping and apical vaginal excision. However, subsequent recurrence is minimal (<1%). More than 90% of patients reported resolution or marked improvement of symptoms.
Magtibay
Paul M
PM
Division of Gynecologic Surgery, Mayo Clinic, Scottsdale, AZ 85259, USA. magtibay.paul@mayo.edu
Nyholm
Jessica L
JL
Hernandez
Jose L
JL
Podratz
Karl C
KC
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000150:complications*; D010052:Ovariectomy / Q000009:adverse effects* / Q000379:methods; D017699:Pelvic Pain / Q000209:etiology*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D012489:Salpingostomy / Q000009:adverse effects* / Q000379:methods; D013577:Syndrome