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Ovarian remnant syndrome


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Overview



What is ovarian remnant syndrome?



What are the signs and symptoms of ovarian remnant syndrome?



How is ovarian remnant syndrome diagnosed?



How might ovarian remnant syndrome be treated?



What are the risk factors for ovarian remnant syndrome?


What is ovarian remnant syndrome?

Ovarian remnant syndrome occurs when ovarian tissue is left behind following surgery to remove both ovaries (bilateral oophorectomy). Common signs and symptoms include a mass and cyclic pelvic pain.[1][2][3]
Last updated: 12/12/2012

What are the signs and symptoms of ovarian remnant syndrome?

Common signs and symptoms of ovarian remnant syndrome include a mass and regular pelvic pain. Ovarian remnant syndrome may cause blockages of the urinary tract.[1][2][3] The Mayo Clinic provides additional information on urinary tract blockages (ureteral obstruction) at the following link:
http://www.mayoclinic.org/ureteral-obstruction/
Last updated: 12/12/2012

How is ovarian remnant syndrome diagnosed?

Ovarian remnant syndrome is suspected in women with a surgical history of bilateral oophorectomy and follicle stimulating hormone (FSH) levels in the premenopausal range or normal serum estradiol levels. Other suggestive signs include persisting periods (in women whose uterus has been retained), relief of symptoms after medical therapy to suppress ovarian function, and a pelvic mass on imaging study (e.g., transvaginal ultrasound, CT scan, or MRI examination).[1][2][3]
Last updated: 12/12/2012

How might ovarian remnant syndrome be treated?

Treatment may involve surgery to remove the remnant ovarian tissue, however the remnant can be very difficult to distinguish from surrounding tissues.[1] Surgery should be performed by highly experienced surgeons. When surgery is not an option, treatment may be aimed at preventing blockages of the urinary tract. There have been individual case reports describing the use of leuprolide acetate therapy for treatment of ovarian remnant syndrome and ureter blockage.[3] Ovarian remnant syndrome may recur following treatment.[1][3]
Last updated: 12/12/2012

What are the risk factors for ovarian remnant syndrome?

Ovarian remnant syndrome is more likely to occur in women who had endometriosis, pelvic inflammatory disease, tumor, prior abdominal or pelvic surgeries, or increased blood vessels in the pelvis prior to surgery. Other risk factors for ovarian remnant syndrome include extra bleeding during the surgery, variations in pelvic anatomy, poor surgical technique, and laparoscopic surgery.[1][2][3]
Last updated: 10/18/2013

References
  1. Valea FA, Mann WJ. Oophorectomy and ovarian cystectomy. In: Basow, DS. UpToDate. Waltham, MA: UpToDate; 2012;
  2. Benign Gynecologic Lesions: Ovarian Remnant Syndrome. In: Lentz. Comprehensive Gynecology, 6th ed. Philadelphia, PA: Mosby; 2012;
  3. Pathophysiology of Urinary Tract Obstruction: Ovarian Remnants. In: Wein. Campbell-Walsh Urology, 10th. ed. Philadelphia, PA: Saunders; 2011;