Residual ovary syndrome

There are many patients with ovarian syndrome in our lives. The so-called ovarian syndrome refers to a variety of diseases in women's ovaries. These diseases will seriously affect women's health and their reproductive function. For women, after getting this disease, it will generally affect women's pregnancy function, so it is necessary to actively treat it. So what is residual ovarian syndrome?

Ovarian remnant syndrome (ORS) refers to a group of syndromes characterized by the reappearance of functional ovarian tissue after vaginal or abdominal removal of both ovaries, and the occurrence of symptoms and signs such as pelvic pain or mass. In 1958, Brentano PF and Grogan RH described this syndrome. Postoperative pathological observation confirmed that patients with this syndrome had ovarian tissue in areas where ovarian tissue should not be present.

Causes

Ovarian remnant syndrome often occurs in patients who have had a history of difficult pelvic surgery. If the first operation is difficult to stop bleeding due to the large number of pelvic blood vessels, or due to adhesions of pelvic tissues making the anatomical relationship unclear and difficult to separate, or because the tumor changes the structure, morphology and adjacent relationships of normal tissues, causing difficulties in surgery, some ovarian tissue may be left behind and not be completely removed. Although the cortex of these remaining ovarian tissues and ovarian tissues in other parts of the pelvis no longer has ovarian blood supply, they can still undergo necrosis, cystic change, and tumor-like change, and even continue to retain their functions. Together with extensive pelvic adhesions, these are the main causes of pain.

Clinical manifestations

Since ORS often occurs after difficult pelvic surgery, its clinical manifestations are relatively complex and can be summarized as follows:

1. The most common clinical manifestation of ORS is lower abdominal pain with pelvic mass. It often occurs within weeks and years after difficult bilateral oophorectomy, and most often occurs within 5 years after surgery. Lower abdominal pain accounts for about 65%, and pelvic masses account for about 75%.

2. The pain manifests in various ways, and may be continuous or intermittent, with periodic or continuous dull pain, stabbing pain, or progressive abdominal pain in one or both sides of the lower abdomen, which may radiate to the perineum and partially to the back. In some cases, the pain is so severe that emergency treatment is required.

3. There is a feeling of pelvic pressure.

4. Most patients experience pain or difficulty during sexual intercourse.

5. A few people may experience rib pain due to invasion of the fallopian tubes and frequent urinary tract infections. Functional ovarian remnant tissue obstructs the bladder outlet, resulting in acute urinary retention. The remaining ovary is prone to cystic changes, causing distal ureteral obstruction. Intravenous pyelography can show ureteral dilatation or displacement, which are characteristics of urinary tract obstruction, with periodic attacks and manifestations such as renal colic, hematuria, and bladder irritation symptoms.