Oophorectomy is a surgical procedure to remove an ovary or both to lower your risk of cancer and/or to treat certain medical conditions around the pelvic region. When only one ovary is removed, it is called Unilateral Oophorectomy while removal of both is called Bilateral Oophorectomy.
The ovaries are situated on each side of the uterus in the pelvis and are almond shaped in size. The ovaries are the reproductive organs that contain eggs releasing one egg every month. They also produce hormones–oestrogen and progesterone that control the menstrual cycle.
Oophorectomy may be performed on its own or combined with the removal of other organs to reduce the high risk of breast cancer or ovarian cancer as the fallopian tubes (Salpingectomy) and ovaries share the same blood supply.
When an ovary and a fallopian tube are removed, the surgery is known as Salpingo-Oophorectomy or Unilateral Salpingo-Oophorectomy (USO). When both the ovaries and both fallopian tubes are removed, it is called Bilateral Salpingo-Oophorectomy (BSO).
Moreover, Oophorectomy can be performed with Hysterectomy (removal of the uterus without the ovaries and fallopian tubes).
Indications for Oophorectomy
- Chronic pelvic pain
- Pelvic inflammation
- Ectopic pregnancy
- Large ovarian cysts
- Benign tumours
- Ovarian cancer
- Ovarian torsion (twisting of an ovary)
- A tubo-ovarian abscess (abscess in a pocket involving the fallopian tube and an ovary)
- To reduce the risk of breast cancer or ovarian cancer in those at high risk women
Diagnosis and tests
- Complete physical examination of the pelvic region
- Blood and urine tests
- CT Scan
Different surgical approaches to Oophorectomy
There are three types of surgical approaches. You may want to discuss with your surgeon to know the best option for you.
- Open Abdominal Surgery: an incision is made on the abdomen to remove the ovaries. This could take time to recover and has a higher risk of complications.
- Laparoscopic Surgery: a laparoscope containing a camera and light is inserted through small cut in the abdomen to better visualise the pelvic organs. With small surgical tools, the ovaries will be removed. This approach takes a shorter time to recover, lower risk of infection and is less painful. However, it takes longer to perform and has a risk of injuring the near by organs or urinary tract.
- Robotic Surgery: this approach enables the surgeon to use a robotic arm to perform the procedure through small incisions. It takes longer than the traditional approach.
- Your doctor will do a physical examination.
- Diagnostic tests should be done as suggested by your doctor.
- Inform your doctor about your medical history including current medications and allergies.
- Your doctor will discuss the best option for your surgery.
- Also, if you still want to be fertile, make sure you discuss with your doctor and explore possible options even if both ovaries need to be removed.
- You will be asked to stop taking certain medications like blood thinners, herbal supplements etc if you are currently taking them.
- You will be asked to stop smoking if you do as it affects the healing process.
- You will be asked to stop eating and drinking 8 – 12 hours before surgery.
- Medications given should be taken with small sips of water.
- You will be given local or general anaesthesia depending on the kind of surgery opted for, but you will not feel any pain.
- You may be given a temporary catheter and IV inserted in your vein.
- The surgery may take around 1 to 4 hours depending on the reasons of surgery.
- The surgeon makes some incision in the abdomen which could be either vertical or horizontal. Vertical incisions give a better view of the organs while horizontal gives a less obvious scar.
- The surgeon will separate the abdominal tissues from the ovaries and blood vessels tied to prevent bleeding.
- The ovary is removed along with another organ depending on the reason for surgery.
- If laparoscopy is done, the surgeon uses a camera, light and surgical tools inside the body and performs the surgery through a monitor.
- If robotic surgery is done, the surgeon uses a robotic arm giving him a finer movement of the surgical tools and watches through a 3-D monitor.
- The incisions are closed and stitched.
- On the same day of the surgery, you will be asked to be up and about, even take a short walk.
- You may spend a night or two in the hospital if it is an abdominal surgery, but with laparoscopic surgery, just an overnight stay is required.
- You may experience some pain and if it is too severe, some pain medication will be provided.
- If both ovaries are removed, you will experience an early menopause and will be placed on hormone replacement medication.
- You may have bloody to light vaginal discharge.
- No tub bathing or sexual intercourse is permitted until permitted by your doctor.
- Eat well and get plenty of rest.
- Being slowly active or walking will help avoid blood clots and pneumonia.
- Avoid strenuous exercises and heavy lifting.
- It may take 6 weeks to fully recover after an open abdominal surgery whereas it may take 2 weeks to swing back to normal activities after laparoscopic or robotic surgery.
- Follow your doctor’s instruction while recovering.
- Inform you doctor immediately if you experience any abnormal symptoms like fever, worsening abdominal pain despite pain prescription, trouble urinating, swelling or redness around the incision area.
Risks and Complications
Serious complications are rare, but complications can arise if you have diabetes, are overweight or smoke. As with any surgery, there are some risks involved and some possible complications are:
- Blood clots
- Damage to nearby organs
- Allergic reaction to anaesthesia
- Ovarian tissue retention
- Bowel obstruction
Factors affecting the cost of Oophorectomy
The cost price may vary depending on certain factors like:
- Medical condition of the patient
- Type of surgery
- Location of the hospital
- Choice of hospital
- Cost of diagnostic tests
- Surgeon’s fee
- Medical treatment
- Duration of hospital stay