Female reproductive system
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.
An oophorectomy (oh-of-uh-REK-tuh-me) is a surgical procedure to remove one or both of your ovaries. Your ovaries are almond-shaped organs that sit on each side of the uterus in your pelvis. Your ovaries contain eggs and produce hormones that control your menstrual cycle.
When an oophorectomy involves removing both ovaries, it's called bilateral oophorectomy. When the surgery involves removing only one ovary, it's called unilateral oophorectomy.
An oophorectomy can also be done as part of an operation to remove the uterus (hysterectomy).
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Why it's done
Ovarian cancer is a type of cancer that begins in the ovaries. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen, progesterone and testosterone.
An oophorectomy may be performed for:
- A tubo-ovarian abscess — a pus-filled pocket involving a fallopian tube and an ovary
- Ovarian cancer
- Noncancerous (benign) ovarian tumors or cysts
- Reducing the risk of ovarian cancer or breast cancer in those at increased risk
- Ovarian torsion — the twisting of an ovary
An oophorectomy is a relatively safe procedure. However, with any surgical procedure, there are risks involved.
Risks of an oophorectomy include the following:
- Damage to nearby organs
- Rupture of a tumor, spreading potentially cancerous cells
- Retention of ovary cells that continue to cause signs and symptoms, such as pelvic pain, in premenopausal women (ovarian remnant syndrome)
- Inability to get pregnant on your own, if both ovaries are removed
Menopause after oophorectomy
If you haven't undergone menopause, you will experience menopause if both ovaries are removed. This deprives the body of the hormones, such as estrogen and progesterone, produced in the ovaries, leading to complications such as:
- Menopause signs and symptoms, such as hot flashes and vaginal dryness
- Depression or anxiety
- Heart disease
- Memory problems
- Decreased sex drive
Undergoing an oophorectomy at a younger age, such as before 45, may increase the risks related to early menopause. Talk with your doctor about the risks as they relate specifically to your situation.
Taking low doses of hormone replacement drugs after surgery and until about age 50 may reduce the risk of these complications. But hormone replacement therapy has risks of its own. Discuss your options with your doctor.
How you prepare
To prepare for an oophorectomy, your doctor may ask that you:
- Stop eating a certain number of hours before your surgery and limit liquids
- Stop taking certain medications
- Undergo imaging tests, such as ultrasound and blood tests, to help surgeons plan for the procedure
Plan for infertility
If you want to have children, talk with your doctor about your options. There may be ways to preserve your ability to become pregnant, depending on your particular situation. Ask your doctor to refer you to a fertility specialist who can review your options with you.
What you can expect
Laparoscopic oophorectomy uses special tools inserted through multiple incisions in your abdomen to remove your ovaries.
During oophorectomy surgery you'll receive anesthetics to put you in a sleep-like state. You won't be aware during the procedure.
An oophorectomy can be performed two ways:
- Laparotomy. In this surgical approach, the surgeon makes one long incision in your lower abdomen to access your ovaries. The surgeon separates each ovary from the blood supply and tissue that surrounds it and removes the ovary.
Minimally invasive laparoscopic surgery. In this surgical approach, the surgeon makes a couple of very small incisions in your abdomen.
The surgeon inserts a tube with a tiny camera through one incision and special surgical tools through the others. The camera transmits video to a monitor in the operating room that the surgeon uses to guide the surgical tools.
Each ovary is separated from the blood supply and surrounding tissue and placed in a pouch. The pouch is pulled out of your abdomen through one of the small incisions.
Laparoscopic oophorectomy can also be done with the assistance of a surgical robot. During robotic surgery, the surgeon watches a 3D monitor and uses hand controls that allow movement of the surgical tools.
Whether your oophorectomy is an open, laparoscopic or robotic procedure depends on your situation. Laparoscopic or robotic oophorectomy usually offers quicker recovery, less pain and a shorter hospital stay. But these procedures aren't appropriate for everyone, and in some cases, surgery that begins as laparoscopic may need to be converted to an open procedure during the operation.
After an oophorectomy, you can expect to:
- Spend time in a recovery room as your anesthesia wears off
- Move to a hospital room where you may spend a few hours to a few days, depending on your procedure
- Get up and about as soon as you're able in order to help your recovery
Most people are able to go home after oophorectomy surgery and won't need to spend the night in the hospital.
How quickly you can go back to your normal activities after an oophorectomy depends on your situation, including the reason for your surgery and how it was performed.
Most people can return to full activity in two to four weeks after surgery.
Discuss exercise, driving, sexual restrictions and overall activity level with your surgeon.
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Aug. 28, 2020