Oophorectomy

What Is an Oophorectomy?

An oophorectomy is surgery to remove your ovaries. You might also hear it called ovary removal surgery.

Reasons for Oophorectomy

There are many reasons your doctor may recommend surgery to remove your ovaries. They include:

• Benign tumors, which are noncancerous growths
• BRCA gene mutations, which are changes in your DNA that make you more likely to have breast or ovarian cancer
• Cysts, a type of noncancerous tumor
• Ectopic pregnancy
• Endometriosis, a condition where cells that normally grow inside your uterus start growing elsewhere
• Ovarian cancer, which is a cancer that starts in your ovaries
• PID, which is when you get an infection in your ovaries or around them (It’s also called pelvic inflammatory disease or a tubo-ovarian abscess.)
• Torsion of the ovary, a condition where your ovary twists around its stalk, where the blood supply is. This might cause you serious pain.
• Treat pelvic pain: It can treat chronic pelvic pain, or pain after an ovary-sparing hysterectomy.

Oophorectomy Procedure

There are several types of oophorectomies. The one you’ll get depends on the medical condition you’re being treated for:

• Unilateral oophorectomy: Remove one ovary
• Bilateral oophorectomy: Remove both ovaries
• Salpingo-oophorectomy: Remove an ovary and fallopian tube (the small organ that guides eggs from your ovary to your uterus)
• Bilateral salpingo- oophorectomy: Remove both ovaries and both fallopian tubes
• Hysterectomy with salpingo-oophorectomy: Remove your uterus and one or both ovaries and fallopian tubes

Usually, you’ll get general anesthesia for surgery and won’t be awake. But in some cases, you may have local anesthesia instead. That means the doctor only numbs the area they’re working on.

There are a few ways the surgery can be done. Your doctor will suggest the method based on your particular situation:

• An open procedure: This is the traditional way to perform the surgery. Your doctor will make one large incision, or cut, in your belly. This lets them see your ovaries, separate each one from other tissues and arteries that supply blood, and then remove them.
• Laparoscopic surgery: Your surgeon will insert a small camera, called a laparoscope, through a tiny cut in your bellybutton. It lets them see your ovaries. The camera sends images to a monitor, just like a TV or computer screen. The doctor will make other small cuts in your belly, as needed, using special surgical tools. They’ll remove the ovaries through a small cut in your belly or vagina. In some cases, the doctor may start to remove your ovaries this way but change to an open procedure once they see what’s happening inside.
• Vaginal approach: This is usually done when you’re also getting your uterus removed (hysterectomy). You have a smaller chance of getting an infection with this type, and you might even recover faster.
• Laparotomy: The doctor will make a large cut on your belly to remove your ovaries. Although your chance of getting an infection is low for any surgery, it’s higher with a laparotomy and it’ll take longer to recover with this method.
• Robotic-assisted ovary removal: Your doctor makes several small incisions to put the robot’s camera and specialized instruments in place. Guided by the camera, your doctor controls the robotic device and uses the special tools on its arms to remove your ovaries.

Oophorectomy Hospital Stay

If your doctor performs an open procedure to remove your ovaries, you can expect to stay in the hospital several days. If you have a laparoscopic or robot- assisted operation, you may stay in the hospital for a day or be released the same day.

Oophorectomy Recovery

The doctor will give you instructions about your return to an active lifestyle. Things you can do to take care of yourself at home include:

• Keeping the area where the doctor made the cut clean and sterile
• Eating plenty of healthy food
• Not driving
• Not exercising (but walking around is OK)
• Not lifting heavy things
• Taking it easy at work, at home, and at school
• Taking the pain medication your doctor suggests

How quickly you can return to normal activities depends on your overall health before surgery, the reason for your surgery, and the way your surgery was done. Most women get back to an active life within 6 weeks of surgery. Women who had laparoscopic surgery or robot-assisted surgery tend to have quicker recoveries -- about 2 weeks.

While you recover, look out for signs that you may need to see the doctor. Some things to watch out for include:

• Blood or liquid coming out of the cut
• Feeling nauseated or throwing up
• A fever over 100.4 F
• Trouble peeing
• Serious pain
• Swelling or redness around the cut
• Vaginal discharge (You might feel itchy or notice a bad smell.)

Risks of Oophorectomy

Although getting an oophorectomy is generally safe, as with any surgery, there are a few risks. They include:

• Bleeding: If you bleed too much during surgery, you may need blood transfusions.
• Damage to nearby organs: Surgery could damage your bladder or bowel, but this is rare. It happens in less than 1% of all cases.
• Infection: You could get one several days, or even several weeks, after surgery. It could cause a fever or redness and pain near the cut.
• Hernia: Sometimes the muscle near the cut gets weak.
• Tumor rupture: Your tumor could burst, spreading cancerous cells into your body.
• Retention of ovary cells: Your ovary cells could keep causing problems, like pain near your pelvis.
• Loss of fertility: If both ovaries are removed, you’ll need a treatment like in vitro fertilization (IVF) to get pregnant.

The doctor will discuss these risks with you before your surgery. If they advise you to have this surgery, it means they think the benefits outweigh the risks for you.

Fertility and Menopause After Oophorectomy

This can cause menopause symptoms like:

• Hot flashes
• Vaginal dryness
• A higher risk of osteoporosis
• Anxiety or depression
• Heart disease
• Problems with memory
• Lowered sex drive

Your doctor may recommend low-dose hormone therapy, or other medications and lifestyle changes, to help you with the symptoms.

Younger women may have concerns about whether they can get pregnant. It will depend on your situation. If the doctor removes only one ovary, the remaining ovary will probably still produce estrogen. That means you’ll still have a menstrual cycle and be able to get pregnant. If they remove both ovaries, you may need a treatment like in vitro fertilization to get pregnant. Sometimes, eggs can be removed from your ovaries before surgery and frozen for future use. Talk to your doctor about your options.

Read more on: ovarian cancer