What is an oophorectomy?
Oophorectomy is a surgical procedure to remove your ovaries. When you have one ovary removed, it’s called unilateral oophorectomy. Removal of both ovaries is called bilateral.
This procedure may be used to treat:
- pelvic inflammatory disease
- chronic pelvic pain
- ectopic pregnancy
- benign tumors
- large ovarian cysts
In women who carry mutations of the BRCA1 or BRCA2 genes, oophorectomy may be performed to lower the risk of ovarian cancer. This is considered an elective or prophylactic oophorectomy.
Most of the production of the female hormones estrogen and progesterone takes place in the ovaries. Removing both ovaries results in menopause and permanent infertility.
Continue reading to learn more about this procedure, why it’s often combined with other procedures, and what that means in the long term.
Oophorectomy can be performed alone, but it’s likely to be part of a multistep procedure. Whether it is depends on the reason for the surgery.
Removal of the ovaries is often combined with salpingectomy, a procedure to remove the fallopian tubes. This might be an option if the oophorectomy is done to lower your risk of ovarian cancer. That’s because the ovaries and fallopian tubes share a blood supply. When both procedures are done at once, it’s called a salpingo-oophorectomy.
A hysterectomy is an operation to remove the uterus. When possible, the ovaries are preserved to prevent premature menopause. Hysterectomy may be combined with oophorectomy in certain circumstances. For example, it may lower the chances of ovarian cancer in women who are at particularly high risk.
There’s a lot to consider when having an oophorectomy, so make time to have this discussion with your doctor.
Discuss family planning and menopause
If both ovaries are removed, you won’t be able to get pregnant. In fact, you’ll be in menopause. If only one is removed, and you still have your uterus, you’ll be less fertile, but you can still conceive.
If you want children, ask your doctor to refer you to a fertility specialist before surgery so you understand your options.
There’s a chance that this procedure will cause an emotional reaction. If you have feelings of sadness or depression, consider seeing a therapist to help you work through it.
Early menopause may also increase your risk of heart disease and osteoporosis. Talk to your doctor about these health risks, as well as the potential benefits and risks of hormone replacement therapy (HRT) after the procedure.
Prepare for surgery
Before scheduling the operation, you’ll probably undergo a few tests such as:
- physical examination
- blood and urine tests
- imaging tests, such as a CT scan or ultrasound
Tell your doctor about any medications you take. Ask if you should stop taking them before surgery. Don’t hesitate to ask questions about the procedure and expected outcome.
Check with your health insurer so you have some idea what your out-of-pocket expenses will be, if any.
Get ready for a hospital stay
Your doctor will provide preoperative instructions so you’ll know what to do before surgery day.
Here are a few tips to help you get ready:
- Arrange transportation home from the hospital because you won’t be allowed to drive.
- Ask someone to help out at home for a few days while you’re recovering. Plan on staying home from work for a few weeks.
- Follow your doctor’s instructions about when to stop eating and drinking (including water) before surgery. This is usually after midnight the night before. If you’re provided with a solution to drink to clean out your intestines, follow those instructions carefully.
- Pack a hospital bag that includes personal items such as a toothbrush and hairbrush. Take a robe and slippers or socks, and the clothes you intend to wear home. It’s a good idea to bring something to read.
The surgery can be performed using a vertical or horizontal abdominal incision. Vertical incisions offer the surgeon a better view, but horizontal incisions leave a less obvious scar.
The surgeon first separates your abdominal muscles to reveal the ovaries. Next, blood vessels are tied to prevent bleeding. After your ovaries are removed, your surgeon uses staples or stiches to close the incision.
Oophorectomy can also be done with a laparoscope, a thin instrument with a small camera on the end. This allows your surgeon to see your organs on a monitor.
In this procedure, the laparoscope is inserted into a tiny incision near your belly button. Your surgeon makes a few other tiny cuts for tools to tie off blood vessels. They next remove your ovaries through a small incision near the top of your vagina or through small cuts in the abdominal wall. Finally, they close off the cuts with a few stitches, and you’re left with several small scars.
For abdominal surgery, you’ll need general anesthesia. The laparoscopic surgery can be performed under general or local anesthesia. The operation can last anywhere from one to four hours, depending on the specifics of the surgery.
After the procedure, you’ll spend an hour or two in the recovery room. Once the anesthesia wears off, you’ll be transferred to a regular room.
That same day, you’ll be encouraged to sit up, stand, and even take a brief walk. You might have a catheter in place, but it’s only temporary. If all is well, it and your IV will be removed the following day.
You’ll probably stay in the hospital for a day or two following abdominal surgery. Laparoscopic surgery may require only one night in the hospital and may cause a little less postoperative pain.
You’ll be provided with postoperative instructions before leaving the hospital. Your doctor will advise you how long you should wait to have sexual intercourse.
Tell your doctor right away if you:
- develop a fever
- have nausea or vomiting for more than a few days
- have more vaginal discharge or bleeding than expected
- have abdominal pain that doesn’t improve with medication or is getting worse
- develop redness or swelling around the incision site
- have trouble urinating
- are coughing, or have shortness of breath or chest pain
- feel depressed
Follow your doctor’s instructions during the recovery time. Eat well and get plenty of rest to allow your body to heal. Frequent movement, such as walking, will help you avoid blood clots. Slowly build up your physical activity as advised.
Side effects of any surgery may include:
- allergic reaction to anesthesia
- blood clots
- damage to nearby organs
If both ovaries were removed, you’ll likely have symptoms of menopause due to the drop in your levels of estrogen and progesterone. Many women are placed on hormone replacement medication.
Symptoms of menopause may include:
- hot flashes
- vaginal dryness
- changes in sex drive
- sadness, anxiety, depression
Menopause also means an end to menstruation and the need for birth control.
Serious complications after oophorectomy are rare, but you may be more prone to complications if you have diabetes, are obese, or are a smoker. Report unusual side effects to your doctor right away.
Recovery time is different for everybody. After laparoscopic surgery, you may be able to return to your normal routine two weeks after surgery. For abdominal surgery, it can take up to six weeks or more for a full recovery.
Your doctor will be able to give you an idea of recovery time based on your personal health profile.
If you had one ovary removed and still have your uterus, you’ll still have periods and will notice little change. If you had both ovaries removed, you’re now postmenopausal.