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Oophorectomy (Ovariectomy; Salpingo-Oophorectomy; Bilateral Oophorectomy; Oophorectomy, Bilateral)

Posted July 1, 2008 8:22 PM
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(Ovariectomy; Salpingo-Oophorectomy; Bilateral Oophorectomy; Oophorectomy, Bilateral)

Pronounced: o-frek-toe-me

by Editorial Staff and Contributors


Definition

This is the removal of one or both (called bilateral oophorectomy) ovaries. This procedure may be combined with the removal of the fallopian tubes (called a salpingo-oophorectomy). Removal of the ovaries and/or fallopian tubes are often done as part of a complete or total hysterectomy.


Parts of the Body Involved

  • Ovaries, possibly fallopian tubes

The Female Reproductive System

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© 2008 Nucleus Medical Art, Inc.


Reasons for Procedure


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
  • Ultrasound—a test that uses sound waves to examine the inside of the body
  • CT scan—a type of x-ray that uses a computer to make pictures of structures inside 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.

Anesthesia

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. Vertical incisions give the surgeon a better view of the abdominal cavity. A vertical incision is more likely to be done if you have cancer. The abdominal muscles are pulled apart so that the surgeon can see the ovaries. The blood vessels are tied off to prevent excess bleeding. Then the ovaries, and often the fallopian tubes, are removed.

Laparoscopic Procedure

The laparoscope 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 (¼-½ inch wide) cuts are made in the abdomen. The doctor inserts slender instruments used 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 cuts. The cuts are all closed with stitches. This will likely leave small scars.

After Procedure

The removed organs are sent to a lab.

How Long Will It Take?

45-160 minutes

Will It Hurt?

You will feel discomfort after your oophorectomy. 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
  • Possible increase in the risk of heart disease and osteoporosis (Hormone replacement therapy (HRT) may 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

  • Abdominal incision: 2-5 days
  • Laparoscopic procedure: 1 day

Postoperative Care

  • Antibiotics are given to reduce the risk of postsurgical infection.
  • If both ovaries are removed, your body goes immediately into menopause. If you are not being treated for breast cancer, your doctor will give you hormone replacement therapy to manage menopause symptoms.
  • Returning to normal activities, such as driving and working, takes 2-6 weeks, depending on the type of surgery.
  • 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 routinely receive other forms of treatment (chemotherapy and/or radiation) in addition to oophorectomy.

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

If both of your ovaries are removed, you will no longer menstruate. You 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 did not 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

RESOURCES:

American Cancer Society
http://www.cancer.org/

American College of Obstetrics and Gynecologists
http://www.acog.org/

National Cancer Institute
http://www.cancer.gov/

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca/

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/

References:

Cancer of the ovary. American College of Obstetrics and Gynecologists website. Available at: http://www.acog.org/publications/patient_education/bp096.cfm. Accessed June 8, 2008.

Endometrial cancer treatment. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/endometrial/Patient/page4#Keypoint14. Accessed June 8, 2008.

Rosenfeld LE. Women and heart disease. Yale University School of Medicine Heart Book website. Available at: http://www.med.yale.edu/library/heartbk/. Accessed February 20, 2008.



Last reviewed January 2008 by Jeff Andrews, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Copyright © 2007 EBSCO Publishing All rights reserved.

Source: EBSCO
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