Operative laparoscopic treatment of ovarian retention syndrome

Abstract

To evaluate the ability to treat ovarian retention syndrome (ORS) by operative laparoscopy. Retrospective observational analysis (Canadian Task Force classification II-2). Pelvic pain referral practice in an university-affiliated community hospital. Thirty consecutive women with ORS. Operative laparoscopy. Salpingo-oophorectomy or oophorectomy was completed laparoscopically in 26 women; conversion to laparotomy was necessary in 4 (13.3%). Mean operating time was 159 +/- 63 minutes, mean blood loss was 119 +/- 152 ml, and mean hospital stay was 1.1 +/- 1.4 days. Complications occurred in four patients (13. 3%); in two (6.6%) they were intraoperative. The mean time interval between hysterectomy and symptoms of ORS was 6.4 +/- 4.6 years. Mean preoperative duration of pain was 40.11 +/- 41.3 months. Of 27 patients with adequate follow-up, 13 (48%) were pain free postoperatively with a mean follow-up of 12.9 +/- 8.2 months. Fourteen women (52%) had recurrent pain with mean time to recurrence of 8.8 +/- 10 months. Mean visual analog pain scores were 7.5 +/- 2. 4 preoperatively and 2.3 +/- 3.1 postoperatively (p <0.001). Endometriosis at time of surgery was associated with a significantly higher risk of recurrent pelvic pain (relative risk = 2.3, 95% confidence intervals 1.1, 5.1). Ovarian preservation was significantly related to recurrence of pain (RR = 2.6, 95% CI 1.52, 4.53) and risk of repeat surgery (RR = 4.4, 95% CI 1.69, 11.33). Ovarian retention syndrome can usually be treated by laparoscopy. Removal of both ovaries, if present, may be necessary to prevent recurrent pain. In our series, 48% of women experienced prolonged relief. (J Am Assoc Gynecol Laparosc 6(3):297-302, 1999)