Analysis of adnexal masses requiring reoperation following hysterectomy

J. Karthiga, Ramya Sundaram, V. E. Valli, M. Muthulakshmi
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2016 · pp. 2952–2955 · doi:10.18203/2320-1770.ijrcog20162875 · W2508628681
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study analyzed ten cases of residual ovaries requiring reoperation after hysterectomy, finding that most occurred within five years, primarily after abdominal hysterectomy, and were associated with chronic pelvic pain and adhesions.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This retrospective descriptive study analyzed 10 cases (2015, SRM Medical College Hospital) of residual ovaries that required reoperation after hysterectomy, identified from medical and operative records. Most patients developed residual ovary syndrome within 5 years, most had abdominal hysterectomy, and the most common symptom was chronic pelvic pain; pelvic adhesions were present in most cases. Pathology in residual ovaries was most often follicular cyst or hemorrhagic corpus luteum, and the authors reported endometriotic cysts in two cases; there was also one secondary malignant ovarian tumor after hysterectomy performed for adenomyosis. The paper’s limitation is its very small, single-year case series design, which restricts generalizability. Relevance to endometriosis: it reports endometriotic cysts among residual ovarian pathologies requiring reoperation, and also includes a patient whose hysterectomy for adenomyosis preceded later ovarian malignancy.

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Abstract

Background: Generally, we would like to preserve ovaries during hysterectomy for benign conditions. Many of them come back with ovarian cysts and pain abdomen. Recently there were ten cases of residual ovaries requiring surgery during a year period which made us analyze these cases.Methods: This retrospective descriptive analysis was conducted in SRM Medical College Hospital and Research Centre. Data about residual ovaries requiring surgery were retrieved from the medical records department and operation records and analyzed.Results: There were ten cases of residual ovaries from January 2015 to December 2015 requiring surgery. In 70% of patients, residual ovary syndrome occurred within 5 years of hysterectomy. Majority (80%) of them were following abdominal hysterectomy. The most common symptom among these patients was chronic pelvic pain. Pelvic adhesions were present in most of the cases. Follicular cyst and hemorrhagic corpus luteum were the commonest pathological findings in the residual ovaries (50%). There were two cases of endometriotic cyst and a case of secondary malignant ovarian tumor with primary growth from stomach in a 40 year old woman for whom hysterectomy was performed five years ago for adenomyosis.Conclusions: When the ovaries are preserved the woman should be properly counseled and should undergo periodic clinical and ultrasonographic follow-up.
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Background

Generally, we would like to preserve ovaries during hysterectomy for benign conditions. Many of them come back with ovarian cysts and pain abdomen. Recently there were ten cases of residual ovaries requiring surgery during a year period which made us analyze these cases.

Methods

This retrospective descriptive analysis was conducted in SRM Medical College Hospital and Research Centre. Data about residual ovaries requiring surgery were retrieved from the medical records department and operation records and analyzed.

Results

There were ten cases of residual ovaries from January 2015 to December 2015 requiring surgery. In 70% of patients, residual ovary syndrome occurred within 5 years of hysterectomy. Majority (80%) of them were following abdominal hysterectomy. The most common symptom among these patients was chronic pelvic pain. Pelvic adhesions were present in most of the cases. Follicular cyst and hemorrhagic corpus luteum were the commonest pathological findings in the residual ovaries (50%). There were two cases of endometriotic cyst and a case of secondary malignant ovarian tumor with primary growth from stomach in a 40 year old woman for whom hysterectomy was performed five years ago for adenomyosis.

Conclusions

When the ovaries are preserved the woman should be properly counseled and should undergo periodic clinical and ultrasonographic follow-up. Metrics

References

Shiber LD, Gregory EJ, Gaskins JT, Biscette SM. Adnexal masses requiring reoperation in women with previous hysterectomy with or without adnexectomy. Eur J Obstet Gynecol Reprod Biol. 2016;200:123-7. Dekel A, Efrat Z, Orvieto R, Levy T, Dicker D, Gal R, et al. The residual ovary syndrome: a 20-year experience. Eur J Obstet Gynecol Reprod Biol. 1996;68(1-2):159-64. Casiano ER, Trabuco EC, Bharucha AE, Weaver AL, Schleck CD, Melton LJ, et al. Risk of oophorectomy after hysterectomy. Obstet Gynecol. 2013;121(5):1069-74. ACOG. ACOG Practice Bulletin No. 89. Elective and risk-reducing salpingo-oophorectomy. Obstet Gynecol. 2008;111(1):231-41. Hwu YM, Wu CH, Yang YC, Wang KG. The Residual ovary syndrome. Zhonghua Yi Xue Za Zhi (Taipei). 1989;43(5):335-40. Christ JE, Lotze EC. The residual ovary syndrome. Obstet Gynecol. 1975;46(5):551-6. Hauser GA. Residual ovary syndrome-significance of medical therapy. Geburtshilfe Frauenheilkd. 1980;40(1):17-24. Carey MP, Slack MC. GnRH analogue in assessing chronic pelvic pain in women with residual ovaries. Br J Obstet Gynaecol. 1996;103(2):150-3. Holub Z, Jandourek M, Jabor A, Kliment L, Wágnerová M. Does hysterectomy without salpingo-oophorectomy influence the reoperation rate for adnexal pathology? A retrospective study. Clin Exp Obstet Gynecol. 2000;27(2):109-12.

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adenomyosischronic_pelvic_pain

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