Ovarian remnant syndrome

Ovarian remnant syndrome (ORS) is a condition found in women who have had their ovaries removed. Sometimes, there is a small piece of ovary tissue that has been left behind, connected to other tissues.

These ovarian remnants can re-implant themselves inside of the abdomen, including on the bladder, bowel, or ureters. This retained ovary tissue can grow into a cyst or cause bleeding, leading to severe pain.

Causes of a remnant of the ovary being left behind during surgery include:

1. pelvic adhesions (scar tissue between organs that makes them stick together)
2. limited view of the ovary during surgery
3. anatomic variations (differences in the location of the organs)
4. bleeding during surgery

Risk factors that make it more likely you will get ORS include:

• a history of endometriosis
• pelvic inflammatory disease
• multiple previous surgeries
• pelvic adhesive disease

Pain

Most women with ORS have chronic pelvic pain, pain with a pelvic mass, or just a pelvic mass. A woman with ORS often experiences severe, sharp, one-sided pelvic pain that is cyclical, like menstrual periods.  Another sign of ORS is still having your period after your ovaries are removed.

Treatment

Surgery

If you have symptoms, treatment is usually a surgery to remove the left-over tissue. Patients who have their ovarian remnant successfully removed are almost always cured of their pain.

Hormonal therapy

Hormonal therapy to suppress ovarian function can be used for those who cannot have surgery or do not have a pelvic mass but still experience symptoms.