Oophorectomy
Oophorectomy (Ovary Removal Surgery)
What is an Oophorectomy?
An oophorectomy is a surgical procedure to remove one or both of your ovaries. Your ovaries are almond-shaped organs that sit on each side of the uterus in your pelvis. Your ovaries contain eggs and produce hormones that control your menstrual cycle.
When an oophorectomy involves removing both ovaries, it's called bilateral oophorectomy. When the surgery involves removing only one ovary, it's called unilateral oophorectomy.
An oophorectomy can also be done as part of an operation to remove the uterus (hysterectomy).
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Before Oophorectomy
Why it's done
An oophorectomy may be performed for:
. A tubo-ovarian abscess — a pus-filled pocket involving a fallopian tube and an ovary
. Ovarian cancer
. Endometriosis
. Noncancerous (benign) ovarian tumors or cysts
. Reducing the risk of ovarian cancer or breast cancer in those at increased risk
. Ovarian torsion — the twisting of an ovary
Risks
An oophorectomy is a relatively safe procedure. However, with any surgical procedure, there are risks involved.
Risks of an oophorectomy include the following:
. Bleeding
. Infection
. Damage to nearby organs
. Rupture of a tumor, spreading potentially cancerous cells
. Retention of ovary cells that continue to cause signs and symptoms, such as pelvic pain, in premenopausal women (ovarian remnant syndrome)
. Inability to get pregnant on your own, if both ovaries are removed
Menopause after oophorectomy
If you haven't undergone menopause, you will experience menopause if both ovaries are removed. This deprives the body of the hormones, such as estrogen and progesterone, produced in the ovaries, leading to complications such as:
. Menopause signs and symptoms, such as hot flashes and vaginal dryness
. Depression or anxiety
. Heart disease
. Memory problems
. Decreased sex drive
. Osteoporosis
Undergoing an oophorectomy at a younger age, such as before 45, may increase the risks related to early menopause. Talk with your doctor about the risks as they relate specifically to your situation.
Taking low doses of hormone replacement drugs after surgery and until about age 50 may reduce the risk of these complications. But hormone replacement therapy has risks of its own. Discuss your options with your doctor.
How you prepare
To prepare for an oophorectomy, your doctor may ask that you:
. Stop eating a certain number of hours before your surgery and limit liquids
. Stop taking certain medications
. Undergo imaging tests, such as ultrasound and blood tests, to help surgeons plan for the procedure
How does an oophorectomy impact my chances of having children?
Removing one ovary will not significantly change your chances of becoming pregnant, assuming your other ovary and fallopian tube are working normally. Removing both tubes and ovaries will mean that the person will no longer be able to become pregnant on their own. Young women who are told they need to undergo removal of both tubes and ovaries should see an infertility doctor to talk about storing eggs before the procedure.
During Oophorectomy
What are the different types of oophorectomies?
Depending on the reason for your surgeon to remove an ovary, he or she may also recommend one of the following types of procedures:
. Unilateral oophorectomy: Removing one ovary (one side).
. Bilateral oophorectomy: Removing both ovaries (both sides).
. Salpingo-oophorectomy: Removing the ovary and fallopian tube—the small organ that helps guide eggs from the ovary to the uterus.
. Bilateral salpingo-oophorectomy: Removing both fallopian tubes and ovaries.
. Hysterectomy with salpingo-oophorectomy: Removing the uterus (hysterectomy) at the same time as removing one or both tubes/ovaries.
What you can expect
During oophorectomy
During oophorectomy surgery you'll receive anesthetics to put you in a sleep-like state. You won't be aware during the procedure.
An oophorectomy can be performed two ways:
. Laparotomy. In this surgical approach, the surgeon makes one long incision in your lower abdomen to access your ovaries. The surgeon separates each ovary from the blood supply and tissue that surrounds it and removes the ovary.
. Minimally invasive laparoscopic surgery. In this surgical approach, the surgeon makes a couple of very small incisions in your abdomen.
The surgeon inserts a tube with a tiny camera through one incision and special surgical tools through the others. The camera transmits video to a monitor in the operating room that the surgeon uses to guide the surgical tools.
Each ovary is separated from the blood supply and surrounding tissue and placed in a pouch. The pouch is pulled out of your abdomen through one of the small incisions.
Laparoscopic oophorectomy can also be done with the assistance of a surgical robot. During robotic surgery, the surgeon watches a 3D monitor and uses hand controls that allow movement of the surgical tools.
Whether your oophorectomy is an open, laparoscopic or robotic procedure depends on your situation. Laparoscopic or robotic oophorectomy usually offers quicker recovery, less pain and a shorter hospital stay. But these procedures aren't appropriate for everyone, and in some cases, surgery that begins as laparoscopic may need to be converted to an open procedure during the operation.
After Oophorectomy
What is the recovery period after having an oophorectomy?
If your surgeon performs your surgery using laparoscopy or a vaginal approach, you may be able to leave the hospital the same day. Patients who have a larger incision (laparotomy) spend between two to four days in the hospital.
Patients are usually told to start walking the same day of their surgery and are able to eat and drink regular foods. Once home, patients are told to hold off from heavy lifting or exercise for a number of weeks. Before leaving the hospital, you will be told how to clean and care for your incision sites.
Your surgeon will tell you what pain medication you can take. Call your surgeon immediately if you have too much pain or bleeding.
What is the long-term outlook for someone who has had an oophorectomy?
Most women are able to resume their normal daily lives two to six weeks after surgery. Hormone replacement therapy can help those who have undergone a bilateral oophorectomy deal with symptoms caused by menopause.
Sources:
. https://my.clevelandclinic.org/health/treatments/17800-oophorectomy
. https://www.mayoclinic.org/tests-procedures/oophorectomy/about/pac-20385030