Oophorectomy

What is an oophorectomy?

An oophorectomy is surgery to remove one or both of your ovaries. Your ovaries are reproductive glands that make hormones to control your menstrual cycle and promote bone and heart health. Ovaries also contain and help grow eggs that can lead to pregnancy. Women have two ovaries, one on each side of their pelvis. An oophorectomy is most commonly performed to treat a disease or reduce your risk of developing certain cancers.

What are the different types of oophorectomies?

There are several different types of oophorectomies. Your surgeon will recommend one of these based on your medical history and symptoms:

• Unilateral oophorectomy: Removing one ovary (one side).
• Bilateral oophorectomy: Removing both ovaries (both sides).
• Salpingo-oophorectomy: Removing one ovary and one fallopian tube (the organ that transports eggs from your ovary your uterus).
• Bilateral salpingo-oophorectomy: Removing both fallopian tubes and ovaries.
• Hysterectomy with salpingo-oophorectomy: Removing your uterus (hysterectomy) at the same time as removing one fallopian tube and one ovary.
• Total hysterectomy with bilateral salpingo-oophorectomy: Removing your uterus, cervix, both fallopian tubes and both ovaries at the same time.

An obstetrician-gynecologist (Ob/Gyn) typically performs an oophorectomy. You’ll get general anesthesia, so you are asleep for the surgery. Less often, the surgery is done under local or regional anesthesia, which means certain areas are numb and you’re awake.

Why is an oophorectomy performed?

A surgeon may remove one or both of your ovaries for several reasons, including:

• Endometriosis — when cells from inside your uterus travel and grow in other parts of your body.
• Benign (non-cancerous) growths known as cysts.
• Preventative surgery for people at a higher risk of breast and ovarian cancer.
• BRCA gene mutations, which are changes to your genes that can lead to breast or ovarian cancer.
• Ovarian cancer.
• Ovarian torsion. This happens when your ovary twists around its blood supply, causing severe pain.
• An infection of the ovary or the area around it, also known as pelvic inflammatory disease (PID) or a tubo-ovarian abscess (TOA).

You won’t be able to get pregnant naturally if both of your ovaries and fallopian tubes are removed. If your uterus remains, you can carry a pregnancy using technologies like IVF (in vitro fertilization). These are important factors to consider if you have a strong desire for children. There may be ways you can preserve your fertility before the procedure. For example, some people can freeze their eggs. Your healthcare provider may recommend you discuss your options with a fertility specialist.

How should I prepare for an oophorectomy?

Your surgeon will review the procedure with you and go over any instructions for pre-and post-operative care. Make sure you understand the risks of surgery, the expected recovery time and how the procedure is performed. Before scheduling the surgery, your surgeon may ask you to have the following tests:

• Physical exam.
• Blood tests.
• Urine tests.
• Ultrasound.
• Magnetic resonance imaging (MRI).

How is an oophorectomy performed?

There are various ways a surgeon can remove an ovary. Each procedure carries its own risk and recovery time.

• Laparoscopic approach: Considered a minimally invasive approach, the surgeon uses a small camera to look inside your abdomen. The surgeon makes other small 1-2 cm incisions on your skin to allow for removal of your ovary. Laparoscopic surgery has a smaller risk of infection and you usually recover faster. In some cases, the surgeon may perform the surgery with the assistance of a robotic arm moving the instruments (while the surgeon guides them).
• Vaginal: This is also considered a minimally invasive approach, with a smaller risk of infection and faster recovery. Vaginal removal of ovaries is usually done at the same time your uterus is being removed through your vagina.
• Laparotomy: In some cases, the surgeon decides that a larger incision is needed to complete the surgery. This incision is known as a laparotomy, and it involves cutting into your abdomen. Laparotomies, or bigger incisions, usually have a longer recovery time and higher risk of complications, although these are still low.

Laparoscopic and vaginal surgery may involve an overnight stay in the hospital, but can typically be performed as an outpatient procedure. This means you’ll return home several hours after surgery. A laparotomy (or open abdominal procedure) may require up to three days in the hospital. Everyone recovers differently, but you can expect three to six weeks of restricted activities. Your surgeon will schedule a follow-up appointment and discuss when you can resume your day-to-day activities.

What happens to your body after an oophorectomy?

Your body will go through different changes depending on the type of oophorectomy you had. If you haven’t reached menopause and had both ovaries removed, you’ll enter menopause immediately. Before surgery, talk to your surgeons about ways to prepare for the hormonal changes you may experience.

Do you still get your period after an oophorectomy?

It depends on what type of oophorectomy you’ve had. If one ovary was removed and the other is still functioning, you’ll still get your menstrual period from the functioning ovary.

Can your ovaries grow back?

No, your ovaries can’t grow back.

What are the benefits of this procedure?

An oophorectomy benefits people who have specific medical conditions or diseases, or people who are at higher risk of developing ovarian cancer. Getting an oophorectomy can treat or minimize symptoms of these diseases or conditions, and prevent ovarian cancer in certain high-risk individuals.

What are the risks of an oophorectomy?

An oophorectomy, like any other surgery, carries some risks. These can include:

• Infection.
• Injury to surrounding organs like your bladder or bowel.
• More bleeding than expected.
• Bad reaction to anesthesia.
• Severe pain caused by surgery or retaining ovarian cells (ovarian remnant syndrome).
• Blood clots.
• Rupture of a malignant tumor, which can spread cancer cells.
• Loss of fertility.

What is the recovery period after having an oophorectomy?

If your surgeon performs your surgery using laparoscopy or a vaginal approach, you may be able to leave the hospital the same day. If you had a laparotomy, you will spend a few days in the hospital. Before leaving the hospital, you will be told how to clean and care for your incisions.

Everyone heals at different rates, but generally, you can expect at least two weeks of restricted activities. In the case of a laparotomy, it may take up to six weeks until you can resume your normal lifestyle. Some general rules after surgery may include:

• No exercise (walking is OK).
• No heavy lifting.
• No sexual intercourse.
• Use sanitary pads only (no tampons).
• No baths (only showers).
• Keep the incisions clean and dry.
• Take pain medicine or antibiotics (to prevent infection) as directed.
• Ask for help from family and friends during your recovery.
• No driving (if you’re taking pain medication that impairs driving).

How does an oophorectomy impact my chances of having children?

Removing one ovary won’t change your chances of becoming pregnant, assuming your other ovary and fallopian tube work normally. Removing both tubes and ovaries will mean that you’re not able to get pregnant on your own. You may need a treatment like IVF. People who have both fallopian tubes and ovaries removed and wish to have children should talk to a fertility specialist before the procedure about freezing eggs for future use.

Will an oophorectomy cause menopause?

Ovaries produce estrogen and progesterone, which help control the menstrual cycle. Removing both ovaries will cause menopause to begin immediately. It’s important to be prepared for symptoms of menopause before surgery.

In addition to no longer having periods, menopause can cause:

• Hot flashes.
• Night sweats.
• Vaginal dryness.
• Osteoporosis.

Your provider may treat you with hormone replacement therapy, depending on why the ovaries were removed.

What is the long-term outlook for someone who has had an oophorectomy?

Most people resume their normal routines two to six weeks after surgery. Hormone replacement therapy can help you deal with symptoms caused by menopause. Depending on your age and health history, your provider may discuss other ways to manage the side effects.

When should I see my healthcare provider?

If you’ve had an oophorectomy, you should watch for these signs:

• Swelling or redness at the incision.
• Leaking fluid or pus from the incision.
• Pelvic pain.
• Swelling or pain in your legs (a sign of blood clots).
• Nausea and/or vomiting.
• Fever or chills.
• Painful urination.
• Foul-smelling or itchy vaginal discharge.

Contact your healthcare provider immediately if you experience these symptoms.

What is the difference between a hysterectomy and an oophorectomy?

A hysterectomy is a procedure to remove your uterus. Your uterus is where a baby grows during pregnancy and where blood and tissue are shed during your menstrual period. A hysterectomy is often performed at the same time as an oophorectomy. An oophorectomy is a procedure to remove one or both ovaries.