Bilateral ovarian maldescent: Unusual cause of infertility – A case report and literature review

Garg, Deepika; Grazi, Richard V.; Kankanala, N; Melzer-Ross, K.

doi:10.1111/jog.13019

Cited by 3 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Maldescended ovaries may be located at various points along the ovarian migration path. In our case, it was seen behind the ascending colon; they have been reported in inguinal hernia[ 5 ] above the pelvic brim[ 6 ] and subhepatic region,[ 7 ] which suggests ovarian maldescent follows the course of the gubernaculum in women. This rare congenital anomaly of the female genital tract may also be accompanied by urinary tract anomalies; therefore, it is advised to review the urological system in the radiological scans and perform ureterolysis during laparoscopic excision, as we did in our case [ Figure 2 ].…”

Section: Discussionmentioning

confidence: 51%

Laparoscopic management of maldescended ovary presenting with recurrent acute abdomen

Ireo

Haruna

Gandhi

2018

Gynecol Minim Invasive Ther

View full text Add to dashboard Cite

Ovarian maldescent is an extremely rare gynecological phenomenon, usually associated with Müllerian abnormalities. We report a 27-year-old woman, presenting with acute, right-sided abdominal pain. She has a history of subfertility and repeated admissions with chronic pelvic pain. Previous hysterosalpingogram and laparoscopy demonstrated unicornuate uterus with absent right fallopian tube and ovary. A right-sided, ectopic ovary was identified on later imaging and suspected as the cause of her symptoms. She underwent laparoscopic excision of the maldescended ovary with remnant fimbrial end and gubernaculum. She was discharged the following day as she was pain-free and remains so 11 months later. This case report prompts a gynecologist to consider diagnosis of maldescended ovary in the women with uterine abnormalities and repeated episodes of abdominal pain. This is the first case report to the best of our knowledge where surgical management of ovarian maldescent was performed via minimal access approach, thus avoiding laparotomy in this acute setting.

show abstract

Section: Discussionmentioning

confidence: 51%

Laparoscopic management of maldescended ovary presenting with recurrent acute abdomen

Ireo

Haruna

Gandhi

2018

Gynecol Minim Invasive Ther

View full text Add to dashboard Cite

show abstract

“…Ovarian maldescent may be unilateral or bilateral, but it has been reported to be more common on the right side and more likely to be located retroperitoneal. 33,34 Our literature research found 39 right UO (52.8%), 23 left UO (31%), and 12 bilateral UO (16.2%). We realised a comparative analysis of the laterality and we discovered that the incidence of the right UO is 59.5% for the symptomatic group (66.6% in children and 57.1% in adults) and 40.7% for the asymptomatic group (with 33.3% left UO).…”

Section: Imaging Diagnosismentioning

confidence: 80%

“…32,33 Another theory is a retarded differential growth of the urogenital ridge's specific region responsible for the formation of the ovaries and fallopian tubes. 34,35 UO may occur in patients with normal uterus. However, although the ovarian embryological development follows a different path than the uterus and fallopian tubes, the UO incidence is higher in the presence of uterine anomalies, particularly the unicornuate uterus (UU) caused by a lack of development of one Müllerian duct or by a disturbed descent to its proper location.…”

Section: Pathogenesis and Associated Malformationsmentioning

confidence: 99%

“…The estimated incidence of UO is 0.3-2%, 1,8,14,45 although other authors consider it to be 0.3-0.5%. 2,6,7,34 The low incidence might be due to underdiagnosis, since ectopic ovaries can be easily missed during routine investigations or are often asymptomatic. The incidence can reach up to 22% when congenital uterine anomalies are associated, 1,9 to 20% in the presence of Mayer-Rokitansky-Küster-Hauser syndrome (agenesis of the uterus, cervix and…”

Section: Incidencementioning

confidence: 99%

See 1 more Smart Citation

Diagnostic and Management of Undescended Ovary – A Preoperative Dilemma: A Case-Based Systematic Review

Ștefanopol¹,

Baroiu²,

Constantin³

et al. 2022

IJWH

View full text Add to dashboard Cite

Undescended ovary (UO) is an uncommon congenital condition characterized by the presence of the adnexa above the common iliac vessels, with an estimated incidence of 0.3-2%. Because of its rarity, it is usually presented as a case report. A thorough knowledge of the ovarian embryological development is essential for the clinician, who must be warned about the possibility of associated Müllerian and renal malformations. There may be asymptomatic patients, incidentally diagnosed during infertility evaluation, but when symptoms occur, these are unspecific and most often this disorder is misdiagnosed, the accurate diagnosis being established intraoperatory. The malignant potential of an UO is accepted, although no such cases were reported. The role of the UO in infertility is still unclear, despite evidence of its normal function. Complications are linked to the ovary (cyst formation, cyst ruptures or tumors) or to the undescended fallopian tube (ectopic pregnancies). The management should be conservative, but there is no consensus about whether it is necessary to excise the ipsilateral undescended tube. We included a short case presentation of an UO cystadenoma misdiagnosed as a renal cyst, which depicts all diagnostic and management dilemmas and inspired us to write this review. The present literature review includes all the cases reported from the early 20th century to the present, with updated data about epidemiology, pathophysiology, clinical and imaging diagnosis, treatment options and prognosis of this rare condition. This paper aims to establish some directions in the diagnosis and management of similar patients and to remind us that, no matter how advanced the imaging investigation techniques might be, a correct preoperative diagnosis may often be missed.

show abstract

“…Typically, undescended ovary with an incidence of 0.3% can be classified into two main categories: one is associated with congenital uterine anomaly, while the other one is not associated with congenital uterine anomaly (isolated) [ 4 , 5 ]. Undescended ovary and fallopian tubes are more often associated with uterine abnormalities.…”

Section: Introductionmentioning

confidence: 99%

Undescended ovary without abnormal development of uterus and urinary system: a report of four cases

Wei

Luo

et al. 2021

J Ovarian Res

View full text Add to dashboard Cite

Background Congenital anatomic abnormalities of fallopian tubes and ovaries are rarely reported. Herein, we describe four cases of undescended ovary during laparoscopic surgery with abnormal anatomy of fallopian tube, yet without abnormal uterine development and urinary system abnormalities, which are analyzed by their clinical features and effects on reproductive function. Case presentation For the patients with undescended ovary, the location of unilateral or bilateral upper poles of the ovaries were usually much higher than that of the bifurcation of the common iliac vessel, and the fallopian tubes at the same side opened in the para-colonic sulcus. Among these four patients, two patients had primary infertility, one patient had tubal pregnancy rupture and bleeding, and one patient had uterine leiomyoma. The development of uterus was normal in all cases, and there was no abnormal development of urinary system. During the infertility examination, the fact that fallopian tubes lifted up in hysterosalpingography (HSG) might be regarded as an indicator of possible undescended ovary. The pelvic ultrasonography examination was of limited use in diagnosing undescended ovary. Conclusion Laparoscopy is the gold standard for the diagnosis of undescended ovary. When there is periodic post-sacral spinal pain, MRI or HSG can be used for diagnosis of undescended ovary.

show abstract

Bilateral ovarian maldescent: Unusual cause of infertility – A case report and literature review

Cited by 3 publications

References 12 publications

Laparoscopic management of maldescended ovary presenting with recurrent acute abdomen

Laparoscopic management of maldescended ovary presenting with recurrent acute abdomen

Diagnostic and Management of Undescended Ovary – A Preoperative Dilemma: A Case-Based Systematic Review

Undescended ovary without abnormal development of uterus and urinary system: a report of four cases

Contact Info

Product

Resources

About