Recurrent endometriosis following hysterectomy and oophorectomy: the role of residual ovarian fragments
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Recurrent endometriosis after hysterectomy and oophorectomy can be stimulated by residual ovarian fragments, which may hypertrophy under increased gonadotropin stimulation and lead to disease reactivation.
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Abstract
Seven women with recurrent endometriosis after definitive surgery were evaluated. Plasma estradiol, FSH and LH indicated that recurrence was stimulated by residual ovarian fragments in six and pseudopregnancy regimen in one. Surgical treatment in two women was followed in one by hypertrophy of another ovarian fragment and reactivation of endometriosis as demonstrated by serial endocrine and ultrasonographic studies. Three patients responded well to hormonal treatment; one required pelvic irradiation. We conclude that: (1) small ovarian fragments may hypertrophy under increased gonadrotropin stimulation, become functional and stimulate recurrence of endometriosis; (2) resection of one such fragment may be followed by reactivation of another.
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Cited by (33)
- Total or Subtotal Hysterectomy for the Treatment of Endometriosis: A Review 2023
- Ovarian remnant syndrome with paraintestinal ovarian serous cystadenofibroma arose 30 years after bilateral salpingo-oophorectomy: A case report 2022
- Pelvic Pain Arising from Ovarian Remnant Syndrome 2021
- RETIRED: No 164 - Directive clinique de consensus pour la prise en charge de la douleur pelvienne chronique 2018
- RETIRED: No. 164-Consensus Guidelines for the Management of Chronic Pelvic Pain 2018
- Surgical challenges in the treatment of perimenopausal and postmenopausal endometriosis 2018
- The management of menopause in women with a history of endometriosis: a systematic review 2017
- Endometriosis 2016
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- Hysterectomy for treatment of pain associated with endometriosis 2006
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- RETIRED: Directive clinique de consensus pour la prise en charge de la douleur pelvienne chronique 2005
- Irradiation ovarienne pour endométriose réfractaire inopérable 2005
- Endometriosis 2003
- Treatment of Endometriosis-Related Pelvic Pain 2003
- Endometriosis-related malignancies 2003
- Endometriosis-related malignancies 2003
- Recurrence of endometriosis in women with bilateral adnexectomy (with or without total hysterectomy) who received hormone replacement therapy 2002
- A case of persistent endometriosis after total hysterectomy with both salpingo-oophorectomy managed by radiation therapy 2001
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