Ovarian Remnant Syndrome
What Is Ovarian Remnant Syndrome?
Ovarian Remnant Syndrome (ORS) is an uncommon disorder which occurs when pieces of ovarian tissue are unintentionally left behind in the body following surgery to remove one or both ovaries. This tissue can develop into cysts or bleeding, causing pain which can be debilitating.
What Are The Causes Of Ovarian Remnant Syndrome?
ORS occurs when, for any reason, ovaries are not completely removed during ovariectomy (also known as oophorectomy – removal of one or both ovaries). This is most commonly caused by the presence of adhesions, which are bands of scar tissue that cause organs to be fused or stuck together. Pelvic adhesions result from previous surgeries or pre-existing conditions such as endometriosis. Anatomical abnormalities in which the ovaries are located in an unusual location may also contribute to the likelihood of tissue being left unremoved. Risk of ORS is increased when the surgeon performing an ovariectomy is unskilled or inexperienced.
What Are The Signs And Symptoms Of Ovarian Remnant Syndrome?
One symptom of Ovarian Remnant Syndrome is lack of menopause and continued production of ovarian hormones (estrogen and progesterone) following surgical removal of the ovaries. ORS commonly causes pelvic pain which may occur on a cyclical basis coinciding with menstrual cycle. Some patients experiencing Ovarian Remnant Syndrome report painful intercourse, urination, or bowel movements. Symptoms typically occur within five years of ovariectomy but may present as much as twenty years following surgery.
What Are The Risk Factors Of Ovarian Remnant Syndrome?
Most patients with Ovarian Remnant Syndrome have some history of endometriosis or other illness-causing pelvic adhesions. Because this condition results from incomplete removal of ovarian tissue, you are at a higher risk of developing ORS if you have had oophorectomy performed by a surgeon who is insufficiently skilled or experienced.
How Is Ovarian Remnant Syndrome Diagnosed?
Laparoscopic surgery is typically required to conclusively identify remaining ovarian tissue and diagnose Ovarian Remnant Syndrome.
What Are The Possible Treatments For Ovarian Remnant Syndrome?
If Ovarian Remnant Syndrome is causing serious pelvic pain and discomfort, treatment may be required. Laparoscopic surgery can be performed to identify and directly remove ovarian tissue.
Are There Preventative Steps Or Measures To Avoid Ovarian Remnant Syndrome?
Ovarian Remnant Syndrome is very rare but is most likely to occur among patients who have had imprecise or incomplete surgery to remove one or both ovaries. Early surgical treatment of endometriosis can reduce the occurrence of pelvic adhesions which make incomplete removal of ovarian tissue more likely. Skill of the physician performing ovary removal surgery is also an important factor in the likelihood of Ovarian Remnant Syndrome.
What Are The Risks If Ovarian Remnant Syndrome Is Left Untreated?
In an undetermined number of cases, Ovarian Remnant Syndrome has no noticeable symptoms and can be left untreated without any serious effects. In other cases, untreated ORS can cause continued growth of cysts which may continue to cause more severe pelvic pain.
Are There Other Related Conditions To Ovarian Remnant Syndrome?
Because it is more common for oophorectomy to leave behind some ovarian tissue in cases where pelvic adhesions are present, endometriosis is a common contributing factor. Pelvic Rehabilitation Medicine offers excision surgery to ensure that all endometrial lesions are successfully removed.
Key Takeaways About Ovarian Remnant Syndrome
Ovarian Remnant Syndrome is a rare disorder that occurs when some ovarian tissue is left behind the following surgery to remove one or both ovaries. It can cause cysts and bleeding which results in serious pelvic pain. Primary risk factors include unusual anatomy of the reproductive organs, surgery performed by an insufficiently skilled or experienced physician, or pelvic adhesions caused by endometriosis or previous surgeries. Ovarian Remnant Syndrome can be diagnosed and treated by laparoscopic surgery during which a physician identifies and removes ovarian tissue directly.
Select Relevant Publications
Shrikhande A, Ahmed T, Shrikhande G, Hill C. A Novel, Non-Opiod Based Treatment Approach to Men with Urologic Chronic Pelvic Pain Syndrome (UCPPS) Using Ultrasound Guided Nerve Hydrodissection and Pelvic Floor Musculature Trigger Point Injections. The International Continence Society. 2018 Aug. Link to Article.
Norman J. Marcus, MD Allyson Augusta Shrikhande, MD Bill McCarberg, MD Edward Gracely, PhD. A Preliminary Study to Determine if a Muscle Pain Protocol Can Produce Long-Term Relief in Chronic Back Pain Patients. Pain Medicine. 2013 Aug; 14(8): 1212–1221. Link to Article.