Features of the retained ovary syndrome:
(1) The patient has a history of hysterectomy with one or both ovaries left in situ.
(2) This ovarian tissue is associated with clinical symptoms such as pelvic pain, asymptomatic pelvic mass, bowel symptoms, or dyspareunia.
(3) Use of high-dose progresterone, lysis of adhesions and/or removal of the ovary can result in symptomatic improvement.
Diagnostic points:
(1) Adhesions are a common finding at reoperation.
(2) Some patients have a history of multiple pelvic operations.
(3) The ovaries usually show some abnormality. Multiple follicular cysts and/or corpora lutea are a common finding. Additional findings may include endometriosis, benign neoplasms or a malignant tumor.
(4) The condition needs to be distinguished from the ovarian remnant syndrome (see the previous section).
(5) The presence of adhesions and anatomical distortions related to the previous surgery increase the risk of injury to the ureters and adjacent structures at the time of reoperation. Some patients may require segmental bowel resection or partial resection of the urinary bladder.
(6) The diagnosis may be difficult to make and the patient may have made numerous visits to other physicians and/or psychiatrists.
(7) Serum FSH levels may be elevated.
