Ovarian remnant syndrome
- Rosanne M Kho, MD
Rosanne M Kho, MD
- Associate Professor
- Head, Section of Urogynecology
- Co-Director, MIGS Fellowship Program
- Columbia University Medical Center
- Mauricio S Abrao, MD
Mauricio S Abrao, MD
- Associate Professor & Director of Endometriosis Division
- Obstetrics & Gynecology Department
- Sao Paulo University, Brazil
Ovarian remnant syndrome (ORS) is defined as the presence of residual ovarian tissue after oophorectomy [1,2]. ORS was first described in 1970 in a report of a study in felines in which ovarian specimens left in the abdominal cavity were able to reimplant and become functional, even after devascularization .
ORS is associated with pelvic pain or pelvic mass after oophorectomy. Though infrequent, this condition presents a challenge to the clinician in its diagnosis and treatment.
The epidemiology, diagnosis, and management of ORS are reviewed here. The technique for oophorectomy is discussed separately. (See "Oophorectomy and ovarian cystectomy".)
Historically, the definition of ovarian remnant syndrome (ORS) included only patients with residual ovarian tissue after bilateral oophorectomy. The definition has since been broadened to include patients with a history of unilateral oophorectomy with ovarian tissue remaining ipsilateral to the side of excision [4,5].
ORS differs from residual ovary syndrome, also known as a retained ovary, in which an ovary is intentionally left in place during surgery and subsequently causes pelvic pain [6,7]. It is also different from supernumerary ovary syndrome, which involves the development of extra ovaries during embryogenesis . (See "Causes of chronic pelvic pain in women", section on 'Ovarian remnant and residual ovary syndrome'.)
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- RISK OF ENDOMETRIOSIS OR OVARIAN CANCER
- ETIOLOGY AND RISK FACTORS
- CLINICAL PRESENTATION
- Pelvic pain
- Pelvic mass
- Symptoms of persistent ovarian function
- DIAGNOSTIC EVALUATION
- Physical examination
- Laboratory evaluation
- Imaging studies
- - Clomiphene provocation
- Surgical exploration
- DIFFERENTIAL DIAGNOSIS
- Indications for treatment
- Choice of treatment method
- - Surgical technique
- - Pharmacologic therapy
- SUMMARY AND RECOMMENDATIONS