Can a partial hysterectomy be associated with bilateral adnexal (adnexa of the uterus) tenderness?

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From the Research

Yes, a person who has had a partial hysterectomy can experience bilateral adnexal tenderness. A partial hysterectomy (also called a subtotal or supracervical hysterectomy) removes the upper portion of the uterus while leaving the cervix intact, but importantly, it does not remove the ovaries and fallopian tubes (adnexa) [ 1 ]. Since these structures remain in place after a partial hysterectomy, they can still develop conditions that cause tenderness or pain, such as ovarian cysts, pelvic inflammatory disease, endometriosis, or ovarian torsion.

Possible Causes of Bilateral Adnexal Tenderness

The adnexa contain numerous pain receptors, and inflammation or other pathological processes in these areas can trigger discomfort that may be felt on examination as bilateral adnexal tenderness. Some possible causes of bilateral adnexal tenderness after a partial hysterectomy include:

  • Ovarian cysts
  • Pelvic inflammatory disease
  • Endometriosis
  • Ovarian torsion
  • Ovarian remnant syndrome, a condition where ovarian tissue is left behind after a hysterectomy and bilateral salpingo-oophorectomy [ 2 ]

Diagnostic Evaluation

Patients who experience persistent adnexal pain after a partial hysterectomy should seek medical evaluation, as this could indicate a condition requiring treatment. Diagnostic tests such as ultrasound or CT imaging may be needed to determine the exact cause of the tenderness [ 1 ].

Treatment and Management

Treatment for bilateral adnexal tenderness after a partial hysterectomy will depend on the underlying cause of the condition. In some cases, surgical excision of the affected tissue may be necessary, while in other cases, medical management with pain relief medications or hormone therapy may be sufficient [ 3 ]. It is essential to seek medical attention if symptoms persist or worsen over time.

References

Research

Adnexal masses requiring reoperation in women with previous hysterectomy with or without adnexectomy.

European journal of obstetrics, gynecology, and reproductive biology, 2016

Research

Ovarian remnant syndrome.

Clinical obstetrics and gynecology, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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