The Efficacy of Laparoscopic Surgical Treatment of Ovarian Remnant and Ovarian Retention Syndromes

Martinez, Anjali; Howard, Fred M.

doi:10.1016/j.jmig.2014.10.007

Cited by 8 publications

(8 citation statements)

References 5 publications

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“…To our knowledge, this is the largest reported cohort of patients undergoing laparoscopic oophorectomy to treat pain following ovary-sparing hysterectomy. The relatively high mean BMI (28) and older mean age (49 years, 5.5 years older than in previous similar studies [1,2,12]) of the women in our study are indicative of the complexity of cases managed at our institution in the context of an aging population and increasing obesity rates in Australia at large [13].…”

Section: Discussionmentioning

confidence: 62%

“…In some women, clear pathology may be present explaining pain symptoms; however, many women with morphologically normal ovaries have residual ovary syndrome (ROS), also known as ovarian retention syndrome. ROS differs from ovarian remnant syndrome (ORS), in which patients who have previously undergone bilateral oophorectomy present with symptoms related to the presence of ovarian tissue unintentionally left behind, causing cyclical pelvic pain and a mass [2].…”

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confidence: 99%

“…ROS was first described as a syndrome of chronic pelvic pain, dyspareunia, and/or an asymptomatic pelvic mass [3,4], but the definition and diagnosis of this condition varies in the literature, with different emphasis placed on the type of pelvic pain or diagnostic process. Some authors have excluded patients with an asymptomatic pelvic mass [2], whereas others have included only women with cyclical pelvic pain who respond initially to ovarian suppression therapy [1]. It has been postulated that the symptoms of ROS may be secondary to inflammation causing perioophoritis, adhesions, and thickening of the ovarian capsule [5], but the pathophysiology and risk factors for developing this condition remain poorly understood.…”

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confidence: 99%

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Laparoscopic Oophorectomy to Treat Pelvic Pain FollowingOvary-Sparing Hysterectomy: Factors Associated with Surgical Complications and Pain Persistence

Richards

Healey

Cheng

et al. 2019

Journal of Minimally Invasive Gynecology

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To examine the surgical management and outcomes of patients treated laparoscopically for pelvic pain following ovary-sparing hysterectomy. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: General gynecology unit at a tertiary university hospital. Patients: A total of 99 patients treated with laparoscopic oophorectomy for pelvic pain following ovary-sparing hysterectomy between January 2008 and December 2016. Interventions: Laparoscopic oophorectomy was performed in all patients. Measurements and Main Results: The patients undergoing surgery had a mean age of 48.9 years and a mean body mass index (BMI) of 28.1. They reported a mean of 3.0 previous abdominal surgeries. Sixty percent of patients reported previous abdominal hysterectomy, 21% had previous laparoscopic hysterectomy, and 19% had previous vaginal hysterectomy. At a 6-week follow-up, 59.5% of patients reported resolution of symptoms, 10.7% reported persistent symptoms, and 29.8% reported improved but not resolved symptoms. Younger patients and those reporting a previous history of gastrointestinal disease were more likely to report persistent pain at follow-up. Thirteen percent of patients had intraoperative (6%) or postoperative complications (7%), and there was a 2% rate of conversion to laparotomy. Patients at greater risk of intraoperative complications were those with a higher BMI, a greater number of previous open abdominal surgeries, or severe adhesions noted at the time of procedure. Conclusions: Laparoscopic oophorectomy to treat pelvic pain following ovary-sparing hysterectomy is a feasible yet challenging procedure. Despite a significant rate of complications and a small proportion of patients reporting persistent symptoms, most experience symptom resolution or improvement after such surgery. Further studies are needed to assess longterm outcomes. Careful patient selection and counseling are critical before this procedure.

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Section: Discussionmentioning

confidence: 62%

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confidence: 99%

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confidence: 99%

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Laparoscopic Oophorectomy to Treat Pelvic Pain FollowingOvary-Sparing Hysterectomy: Factors Associated with Surgical Complications and Pain Persistence

Richards

Healey

Cheng

et al. 2019

Journal of Minimally Invasive Gynecology

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“…One must consider that dissection of adherent visceral structures is much more difficult via laparoscopy and that the absence of tactile sensation may lead to incomplete removal of the ovaries (Rana et al, ). Martinez and Howard () revealed that laparoscopy was effective in pain relief in both ORS and ovarian retention syndrome, with no statistical significance difference. However, patients with ORS were associated with having undergone a higher frequency of previous surgical procedures ( P = .049) and were more likely to develop postoperative complications ( P = .03).…”

Section: Ovarian Remnant Syndromementioning

confidence: 99%

Clinical anatomy of pelvic pain in women

2018

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Pelvic pain is a common symptom that affects women worldwide and usually presents with variable range of severity, duration, and location. Several gynecological conditions may result in pelvic pain, and may have a variable presentation among patients. Pelvic pain creates a significant challenge and frustration to both patients and clinicians, which also creates a significant burden on the economy. It is necessary to tailor the management of pelvic pain to each individual patient to achieve optimal outcomes. Endometriosis, adenomyosis, and fibroids result in pelvic pain and may occur simultaneously. This review highlights some of the common gynecological etiologies of pelvic pain with a focus on anatomy, diagnosis, and management. Clin. Anat. 9999:1–5, 2018. © 2018 Wiley Periodicals, Inc.

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“…Surgery for endometriosis can be very complex and, in some cases, when more than a simple endometrioma excision is required, the gynecologist may request an interdisciplinary approach to safely perform an extensive dissection within the pelvis. Incomplete removal of ovarian disease can lead to partial resolution of symptoms and the need for additional surgery or medical treatment (44). Shervin et al (45) evaluated the reproductive outcome following laparoscopic excision of endometriosis in infertile women with DIE, with and without endometrioma.…”

Section: Introductionmentioning

confidence: 99%

From Endometriosis to Pregnancy: Which is the “Road-Map”?

Zupi

Felice

Conway

et al. 2017

Journal of Endometriosis and Pelvic Pain Disorders

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with severe endometriosis is associated with significantly lower pregnancy rates when compared with women without endometriomas (5). The negative impact of surgical excision of an endometrioma on ovarian reserve and on anti-Müllerian hormone (AMH) levels has been demonstrated (6). Despite the fact that surgery for deep infiltrating endometriosis (DIE) may increase spontaneous conception (7), recent guidelines do not recommend surgery with the single aim of improving assisted reproductive technology (ART) outcomes (6). Several studies have taken into consideration how endometriosis affects pregnancy achievement and pregnancy development, including obstetric complications (8). Pregnancy complications accompanying preexisting endometriosis may be explained by some pathogenic mechanisms, such as endometriosis-related chronic inflammation (9), the presence of adhesions and their mechanical implications (10), and the invasion of decidualized ectopic endometrium in to the vessels wall (11, 12). The aim of this review is to analyze the current literature regarding the relationship between different forms of endometriosis (endometrioma, peritoneal endometriosis, DIE) and infertility, and the impact of endometriosis on pregnancy outcomes. Does endometrioma mean infertility? Endometrioma is a frequently encountered entity in ovarian surgery and affects from 17% to 44% of patients with endometriosis (13). The most common symptoms of ovarian endometriomas include dysmenorrhea, chronic pelvic pain, dyspareunia, and infertility. Transvaginal ultrasound (TVU) has a high diagnostic accuracy for the diagnosis of endometrioma

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The Efficacy of Laparoscopic Surgical Treatment of Ovarian Remnant and Ovarian Retention Syndromes

Cited by 8 publications

References 5 publications

Laparoscopic Oophorectomy to Treat Pelvic Pain FollowingOvary-Sparing Hysterectomy: Factors Associated with Surgical Complications and Pain Persistence

Laparoscopic Oophorectomy to Treat Pelvic Pain FollowingOvary-Sparing Hysterectomy: Factors Associated with Surgical Complications and Pain Persistence

Clinical anatomy of pelvic pain in women

From Endometriosis to Pregnancy: Which is the “Road-Map”?

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