The syndrome is defined as the persistence of the ovarian function even after an apparently bilateral oophorectomy. Oophorectomy becomes technically difficult during hysterectomy in cases with extensive endometriosis or pelvic inflammatory disease. Pain is due to the remnant of ovarian cortical tissue, left behind (retroperitoneally) unintendedly following a difficult oophorectomy.
The presenting complaints are chronic pelvic pain (cyclic), deep dyspareunia and persistence of symptoms of endometriosis. Confirmation is done by serum FSH levels in premenopausal range.
Laparoscopic visualization of the remnant ovarian tissue is difficult because of adhesions. Vaginal ultrasound and MRI are helpful to the diagnosis. Ovarian suppression as mentioned above may be used for diagnosis. Careful dissection is needed as it is adjacent to the ureter in the retroperitoneal space.
Common symptoms of ovarian remnant syndrome include:-
The medicines that can be thought of use are: -