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

Physical examBlood testsUrine testsUltrasounda test that uses sound waves to examine the inside of the body CT scana 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. AnesthesiaGeneral for an abdominal incision Local for a laparoscopic procedure Description of the ProcedureThere are two different methods of oophorectomy: Abdominal IncisionThe 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 ProcedureThe 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 (- 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 ProcedureThe 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 ComplicationsChanges in sex driveHot 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 anesthesiaInternal bleedingBlood clots, particularly in the veins of the legsAccidental damage to other pelvic and abdominal organsInfection Average Hospital StayAbdominal incision: 2-5 daysLaparoscopic procedure: 1 day Postoperative CareAntibiotics 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 OccursSigns of infection, including fever and chillsPersistent or increased vaginal bleeding or dischargeSevere painRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision sitesDifficulty urinatingCough, shortness of breath, chest pain, severe nausea, or vomiting RESOURCES: American Cancer Societyhttp://www.cancer.org/ American College of Obstetrics and Gynecologists http://www.acog.org/ National Cancer Institutehttp://www.cancer.gov/ CANADIAN RESOURCES: Canadian Cancer Societyhttp://www.cancer.ca/ The Society of Obstetricians and Gynaecologists of Canadahttp://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, MDPlease 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.