Delayed re-laparotomy after total hysterectomy

Paridhi Bhatnagar, Erika Desai, Uday Patel, Bakul Leuva
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2013 · pp. 12–15 · doi:10.5455/2320-1770.ijrcog20130202 · W2115172569
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

This retrospective study examined 37 patients who underwent re-laparotomy after hysterectomy, finding simple ovarian cysts to be the most common cause.

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This retrospective, hospital-based study examined 37 post–total hysterectomy patients who underwent delayed re-laparotomy over a 3-year period (June 2009 to May 2012), focusing on the occurrence of impaired ovarian function or failure after ovarian preservation. The most common reason/pathology found at re-laparotomy was a simple ovarian cyst (45.95%), with endometriotic cysts accounting for 21.62% and additional diagnoses including mucinous and serous ovarian tumors and some ovarian adenocarcinomas. The authors note that the appearance of a pelvic mass after hysterectomy creates diagnostic and therapeutic challenges, and they emphasize the need for close post-treatment surveillance due to both recurrent disease and ovarian function considerations. Relevance to endometriosis: the paper specifically reports endometriotic cysts as a major pathology (21.62%) among cases requiring delayed re-laparotomy after hysterectomy, though the overall focus is on post-hysterectomy management and the implications of ovarian preservation.

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Abstract

Background: Since beginning it’s a dilemma whether to remove or preserve the ovaries. In the present study an attempt is made to understand this phenomenon and to have some direction for removal of ovaries. Preservation of the ovaries at the time of hysterectomy does not seem to compromise patient care. Impaired function or failure of the retained ovaries, however, is not uncommon; close post-treatment surveillance is therefore important in terms not only of recurrent disease but of function of the ovaries as well.Methods: This study was done on 37 patients in duration of 3 years from June 2009 to May 2012. It is a retrospective statistical hospital based study of re-laparotomy done in post hysterectomised patients.Results: The most common pathology in these patients was a simple ovarian cyst (45.95%), followed by endometriotic cyst (21.62%), mucinous adenoma (8.10%), serous cyst adenoma (5.40%), serous cyst adenocarcinoma (2.70%) and poorly differentiated adenocarcinoma (2.70%).Conclusions: Emergence of pelvic mass after hysterectomy poses diagnostic and therapeutic challenge to gynecologists. In future, as the patients become more aware and the clinicians more enlightened on the long term benefits and risks of hormone replacement therapy, decisions might be easier for the patients and the clinicians alike.
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Keywords

Adenocarcinoma, Relaparotomy, HysterectomyAbstract

Background

Since beginning it’s a dilemma whether to remove or preserve the ovaries. In the present study an attempt is made to understand this phenomenon and to have some direction for removal of ovaries. Preservation of the ovaries at the time of hysterectomy does not seem to compromise patient care. Impaired function or failure of the retained ovaries, however, is not uncommon; close post-treatment surveillance is therefore important in terms not only of recurrent disease but of function of the ovaries as well.

Methods

This study was done on 37 patients in duration of 3 years from June 2009 to May 2012. It is a retrospective statistical hospital based study of re-laparotomy done in post hysterectomised patients.

Results

The most common pathology in these patients was a simple ovarian cyst (45.95%), followed by endometriotic cyst (21.62%), mucinous adenoma (8.10%), serous cyst adenoma (5.40%), serous cyst adenocarcinoma (2.70%) and poorly differentiated adenocarcinoma (2.70%).

Conclusions

Emergence of pelvic mass after hysterectomy poses diagnostic and therapeutic challenge to gynecologists. In future, as the patients become more aware and the clinicians more enlightened on the long term benefits and risks of hormone replacement therapy, decisions might be easier for the patients and the clinicians alike.

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