Ovarian remnant syndrome is a rare condition where small pieces of ovarian tissue are inadvertently left in the pelvic cavity, following the surgical removal of one or both ovaries. The remnant tissue can grow, form cysts or hemorrhage, producing pain. Ovarian remnants can re-implant themselves anywhere in the abdominal cavity, including the bladder, bowel and ureters.

Risk Factors

Women are at increased risk of developing ovarian remnant syndrome when severe adhesions are found at the time of surgery. Only an experienced surgeon can appropriately dissect and remove the ovary and the surrounding adhesive tissue, decreasing the incidence of ovarian remnant syndrome.

Symptoms

Common symptoms of ovarian remnant syndrome include:

  • Pelvic pain (constant or cyclic)
  • Painful intercourse
  • Painful urination or bowel movements
  • Pelvic mass

Diagnosis

Ovarian remnant syndrome is diagnosed based on detailed medical history, physical examination, ultrasound an occasionally an MRI to locate remnants of ovarian tissue.

Treatment

Ovarian remnants generally do not respond well to hormone therapy. In most cases, the best treatment option is laparoscopic surgery to remove the ovarian remnant. Although these surgeries can be challenging due to the presence of scar tissue from previous surgeries, the improved visualization and accessibility afforded by laparoscopy make localization and removal of the remnant possible.