Oophorectomy

The surgical removal of one or both (called bilateral oophorectomy) ovaries. This procedure may be combined with the removal of the fallopian tubes, in which case it is called a salpingo-oophorectomy. Removal of the ovaries and/or fallopian tubes are often done as part of a hysterectomy

Parts of the Body Involved

Ovaries, possibly fallopian tubes

Reasons for Procedure

  • To treat cancer of the ovary, uterus, or endometrium.
  • To remove a large ovarian cyst.
  • To treat breast cancer by removing the ovary, which is the source of estrogen. The growth of many breast cancers is stimulated by estrogen.
  • To treat chronic pelvic pain, particularly that caused by endometriosis
  • To remove a fertilized ovum that has incorrectly implanted on the ovary
  • To treat pelvic inflammatory disease (PID)

Risk Factors for Complications during the Procedure

  • Presence of scar tissue and/or abscesses in the abdomen
  • Obesity
  • Smoking

What to Expect

Prior to Procedure

Your physician will likely do the following:
  • Physical exam
  • Blood tests
  • Urine tests
  • Possibly, ultrasound � a test that uses sound waves to examine the inside of the body
  • Possibly, CT Scan - a type of x-ray that uses a computer to make pictures of the inside of the body
The day before and the day of your surgery:
  • The night before, eat a light dinner and do not eat or drink anything, including water, after midnight
  • The surgical area will be shaved
During Procedure - IV fluids, anesthesia, and medications

Anesthesia - General for an abdominal incision; general or local for a laparoscopic procedure

Description of the Procedure - There are two different methods of oophorectomy:

Abdominal incision: The surgeon makes a 4-6 inch (10-15 cm) incision either horizontally across the pubic hair line or vertically from naval to pubic bone. Horizontal incisions leave a less noticeable scar, but vertical incisions give the surgeon a better view of the abdominal cavity. A vertical incision is more likely to be done when cancer is suspected. Once the incision is made, the abdominal muscles are pulled apart so that the surgeon can see the ovaries, and the blood vessels are tied off to prevent excess bleeding. Then the ovaries, and often the fallopian tubes, are removed.

Laparoscopic procedure: The laparoscope a small, telescope-like device, about the width of a pencil, with a light on one end and a magnifying lens on the other is inserted through a small cut near the navel. An attached camera allows the surgeon to see the abdominal cavity and pelvic organs on a video monitor.

Other small (1/4 to 1/2 inch wide) cuts are made in the abdomen, through which the doctor inserts slender instruments with which to cut and tie off the blood vessels and fallopian tubes. The ovaries are detached and removed through a small incision at the top of the vagina. The ovaries can also be cut into smaller sections and removed through the tiny abdominal incisions. The cuts are all closed with stitches, which will likely leave small scars.

After Procedure - The removed organ(s) are sent to a lab to be analyzed

How Long Will It Take? 45 to 160 minutes

Will It Hurt? You will feel discomfort after your oophorectomy, but the degree depends on which type of surgery is done. Women report less pain after a laparoscopic procedure than the abdominal incision procedure.

Possible Complications:
  • Changes in sex drive
  • Hot flashes and other symptoms of menopause, if both ovaries are removed
  • Removing both ovaries increases the risk of heart disease and osteoporosis; taking hormone replacement therapy can help reduce this risk
  • Depression and other forms of psychological distress
  • Reaction to anesthesia
  • Internal bleeding
  • Blood clots, particularly in the veins of the legs
  • Accidental damage to other pelvic and abdominal organs
  • Infection
Average Hospital Stay - For the abdominal incision, 2-5 days; for the laparoscopic procedure, 1 day

Postoperative Care:
  • Antibiotics are given to reduce the risk of post-surgical infection.
  • If both ovaries are removed, your body goes immediately into menopause. If you are not being treated for breast cancer, your doctor will prescribe hormone replacement therapy (HRT), either estrogen alone or with progesterone, to help manage the symptoms of menopause.
  • Return to normal activities, such as driving and working, takes from 2-6 weeks, depending on the type of surgery you had.
  • Some women experience emotional distress following the removal of their ovaries; if you do, you may benefit from counseling and/or a support group.

Outcome

The outcome depends on which condition the oophorectomy was done to treat. For example, ovarian cancer is rapidly spreading and often not diagnosed until it is well established. Removing the ovaries will not eliminate the cancer if it has already spread. Patients with ovarian cancer, therefore, routinely receive other forms of treatment (chemotherapy and/or radiation) in addition to oophorectomy.

Endometriosis can be successfully treated with an oophorectomy, although it often requires identification and treatment of other endometrial areas outside of the ovaries at the time of surgery.

If both of your ovaries are removed, you will no longer menstruate and will no longer be able to become pregnant. If one ovary or even just a portion of an ovary remains, you will still menstruate and may be able to become pregnant (assuming you do not also have a hysterectomy).

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Persistent or increased vaginal bleeding or discharge
  • Severe pain
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
  • Difficulty urinating
  • Cough, shortness of breath, chest pain, severe nausea or vomiting