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What to Expect from Salpingo-Oophorectomy

Overview

Salpingo-oophorectomy is surgery to remove the ovaries and fallopian tubes.

Removal of one ovary and fallopian tube is called a unilateral salpingo-oophorectomy. When both are removed, it’s called a bilateral salpingo-oophorectomy.

This procedure is used to treat a variety of conditions, including ovarian cancer.

Sometimes healthy ovaries and fallopian tubes are removed to help prevent ovarian cancer in women who are at particularly high risk. This is known as a risk-reducing salpingo-oophorectomy. This surgery has been shown to be highly effective in lowering the risk of breast and ovarian cancer. Learn more about the causes and risk factors for ovarian cancer.

Salpingo-oophorectomy doesn’t involve removal of the uterus (hysterectomy). But it’s not uncommon for both procedures to be performed at the same time.

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Candidacy

Who should have this procedure?

You might be a good candidate for this procedure if you need treatment for:

It can also be used to reduce the risk of ovarian and breast cancer in women who are at high risk, such as those who carry BRCA gene mutations. Reducing the risk of breast and ovarian cancer may be a viable and cost-effective option.

After your ovaries are removed, you’ll be infertile. That’s an important consideration if you’re premenopausal and would like to conceive a child.

Preparation

How do I prepare?

Once both ovaries and fallopian tubes are removed, you’ll no longer have periods or be able to get pregnant. You’ll have reached menopause. So if you still want to get pregnant, discuss all your options with your doctor. It may be wise to meet with a fertility expert before scheduling the surgery.

The surgery can be performed using a large incision, a laparoscope, or a robotic arm. Ask your doctor which type is best for you and why.

Because your ovaries produce most of the estrogen and progesterone in your body, ask about the pros and cons of hormone replacement therapy. Tell your doctor about any other health conditions and all the medications you take.

Be sure to contact your insurer to find out if they’ll cover this procedure. Your doctor’s office should be able to help you with this.

Here are a few more presurgery tips:

  • You won’t be able to drive yourself home from the hospital, so line up a ride in advance.
  • Arrange for help after surgery. Think about child care, errands, and household chores.
  • If you work, you’ll want to arrange time off with your employer so that you can recover from the procedure. You may be able to use short-term disability benefits, if available. Talk to your human resources department to learn about your options.
  • Pack a hospital bag with slippers or socks, a robe, and a few toiletries. Don’t forget to bring loose-fitting clothes that are easy to put on for the trip home.
  • Stock the kitchen with necessities and prepare a few days’ worth of meals for the freezer.

Your doctor will provide instructions about when to stop eating and drinking prior to surgery.

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Procedure

What happens during the procedure?

Salpingo-oophorectomy can be approached several ways. The surgery usually takes between one and four hours.

Open abdominal surgery

Traditional surgery requires general anesthesia. The surgeon makes an incision in your abdomen and removed the ovaries and fallopian tubes. Then the incision is stitched, stapled, or glued.

Laparoscopic surgery

This procedure can be performed under general or local anesthesia. A laparoscope is a tube with a light and a camera, so your surgeon can see your pelvic organs without making a large incision. Instead, several small incisions are made for the surgeon’s tools to access the ovaries and fallopian tubes. These are removed through the small incisions. Finally, the incisions are closed.

Robotic surgery

This procedure is also done through small incisions. The surgeon uses a robotic arm instead of a laparoscope. Equipped with a camera, the robotic arm allows for high-definition visualization. Precise movements of the robotic arm allow the surgeon to locate and remove the ovaries and fallopian tubes. The incisions are then closed.

Recovery

What’s the recovery like?

Laparoscopic or robotic surgery may involve an overnight hospital stay but can sometimes be done on an outpatient basis. The open abdominal procedure may require a few days in the hospital.

After surgery, you may have bandages over your incisions. Your doctor will tell you when you can remove them. Don’t put lotions or ointments on the wounds.

Your doctor will probably prescribe antibiotics to prevent infection. You may also need pain medication, especially if you have open surgery.

Shortly after you wake up, you’ll be encouraged to get up and walk. Moving around frequently will help prevent blood clots. You’ll also be instructed to avoid lifting more than a few pounds or engaging in strenuous exercise for a few weeks.

You can expect some vaginal discharge following surgery, but avoid tampons and douching.

You might find loose clothing more comfortable during the healing process.

Depending on the specifics of your surgery, your doctor will give you instructions regarding bathing and showering, and when you can resume sexual activity. Your doctor will also let you know when to come in for a follow-up.

Remember, everyone recovers at their own rate. In general, laparoscopic and robotic surgeries cause less postsurgical pain and less scarring than an abdominal incision. You may be able to resume normal activities within two to three weeks, versus six to eight weeks for abdominal surgery.

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Risks

What are the side effects and risks?

Salpingo-oophorectomy is considered a relatively safe procedure, but as with any surgery, it has some risks. These include bleeding, infection, or a bad reaction to anesthesia. Other potential risks are:

  • blood clots
  • injury to your urinary tract or surrounding organs
  • nerve damage
  • hernia
  • formation of scar tissue
  • bowel obstruction

Tell your doctor right away if you have:

  • redness or swelling at the incision site
  • fever
  • drainage or opening of the wound
  • increasing abdominal pain
  • excessive vaginal bleeding
  • foul-smelling discharge
  • difficulty urinating or moving your bowels
  • nausea or vomiting
  • shortness of breath
  • chest pain
  • fainting

If you aren’t already beyond menopause, removing both ovaries may immediately cause side effects associated with this transition. These may include:

  • hot flashes and night sweats
  • vaginal dryness
  • difficulty sleeping
  • anxiety and depression

In the long term, menopause increases the risk of heart disease and osteoporosis. Learn more about what to expect during menopause.

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Outlook

Outlook

Salpingo-oophorectomy has been shown to increase survival for women who carry BRCA gene mutations.

You’ll be able to return to your normal activities within two to six weeks.

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