Ovarian Remnant Syndrome

From: Helen Dynda (olddad66@runestone.net)
Mon Aug 13 23:06:40 2001


[] Question: Ovarian Remnant Syndrome

http://www.obgyn.net/cpp/cpp.asp?page=/cpp/ATE_0201#12

I am a 33 year old woman that has had several operations to correct several different reproductive problems. I have had a complete hysterectomy and double oophorectomy 10 years ago. Three years ago I started having severe pelvic pain, and had an ultrasound done. The ultrasound showed what appeared to be ovaries, but enlarged. The doctor wanted to operate immediately because he said that I had ovarian remnant syndrome, meaning my body made "new" ovaries after the others were removed. He said that my body did not absorb the little cells left from the surgery, and made the ovarian tissue grow. Three years later I am going to have a 3rd surgery for this. Please tell me your thoughts because my body cannot take many more surgery's. Laparoscopy is not possible because of the scar tissue from the others. Will my body ever stop making these remnants? If it does not, what other solutions besides surgery, Lupron, or living with the pain, do I have?

Answer:

I'm not aware that ovarian tissue appears after complete removal. Rather, ovarian remnant syndrome can occur if (and this is something that can occur even among the best surgeons) a small amount of ovarian tissue remains after excision of the ovaries. The tissue that remains is often functional, and may be walled off by pelvic adhesions resulting in pain. Treatment generally consists of surgery (either laparotomy or, in very experienced hands, laparoscopy) to remove the ovarian remnants). So long as the remnants are completely removed (which may sometimes be extremely difficult), the syndrome should not persist. Of course, pelvic adhesions can still result from such surgery and this alone can cause pain. Whether or not this is what is going on in your situation is something you and your doctor can best judge based on your medical evaluation.

How best to proceed is something that should be discussed with your personal physician, and depends on many factors. Good luck, and thank you for your e-mail!

David Toub, M.D.


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