What is an oophorectomy?
An oophorectomy is the surgical removal of one or both ovaries. It treats reproductive conditions such as ovarian cancer, breast cancer, ovarian cysts, and endometriosis. The ovaries are glands that produce a woman’s eggs and female hormones. If your doctor removes both of your ovaries, you will enter menopause and stop having reproductive functions. This means you will no longer have a menstrual period or be able to get pregnant.
Oophorectomy is a common but major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment options before having an oophorectomy.
Types of oophorectomy
The types of oophorectomy procedures include:
Bilateral oophorectomy is removal of both of the ovaries.
Unilateral oophorectomy is removal of only one of the ovaries.
Other surgical procedures that may be performed
Your doctor may perform other procedures in addition to an oophorectomy. These include:
Hysterectomy is the removal of a woman’s uterus. The uterus is a pear-shaped organ in the lower abdominal (pelvic) area where a baby grows during pregnancy.
Salpingectomy is the removal of one or both fallopian tubes, which connect the ovaries to the uterus. Salpingectomy is often combined with oophorectomy. If one fallopian tube is removed with one ovary, the surgery is a unilateral salpingo-oophorectomy. If both fallopian tubes are removed with both ovaries, it is a bilateral salpingo-oophorectomy.
Why is oophorectomy performed?
Your doctor may recommend an oophorectomy to treat certain diseases and conditions of the ovaries and reproductive system. Your doctor may only consider an oophorectomy for you if other treatment options that involve less risk of complications have been ineffective.
Ask your doctor about all of your treatment options. Consider getting a second opinion, especially if you still want to bear children or have not yet reached menopause.
Your doctor may recommend an oophorectomy to treat:
Breast cancer, specifically hormone-dependent breast cancer in premenopausal women with normal ovarian function. Removing the ovaries drastically reduces estrogen production in the body. This can help shrink tumors, prevent the spread, and lower the chances of reoccurrence of hormone-dependent cancer.
Endometriosis, an abnormal uterine tissue growth that causes severe menstrual pain, chronic low back and pelvic pain, and abnormal vaginal bleeding. Medications or a minimally invasive laparoscopic procedure to remove the endometrial lesions can often treat endometriosis.
Ovarian cancer. Your doctor may also recommend oophorectomy to prevent you from getting ovarian cancer if you have inherited a high risk for getting ovarian cancer. This is called prophylactic oophorectomy.
Ovarian conditions including benign ovarian tumors, cysts and abscesses as well as ovarian torsion (twisted ovaries)
Who performs oophorectomy?
The following specialists perform oophorectomies:
Obstetrician-gynecologists specialize in women’s reproductive health and pregnancy.
Oncologists and gynecologic oncologists specialize in diagnosing, treating and preventing cancer. Gynecologic oncologists are surgeons who further specialize in treating cancers of the female reproductive system.
General surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions.
How is oophorectomy performed?
Your doctor will perform an oophorectomy in a hospital or surgical center as an open procedure or as a minimally invasive laparoscopic procedure.
Surgical approaches to an oophorectomy
Your doctor will perform an oophorectomy using one of the following approaches:
Abdominal oophorectomy (open oophorectomy) is the removal of the ovaries through a five to seven inch incision in the lower part of your belly. The incision may be vertical or horizontal. A horizontal incision (bikini cut) is placed very low on the abdomen so it is not easily visible. Open surgery allows your doctor to directly see and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.
Laparoscopic oophorectomy is the removal of the ovaries and fallopian tubes through several small incisions in your abdomen. Your doctor inserts a small tube fitted with a special camera and other surgical instruments through the small incisions to remove the ovaries. The camera transmits pictures of the inside of your body to a video screen. Your doctor sees the inside of your abdomen on the screen while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. A vaginal approach can also be performed, especially when combined with hysterectomy.
Your doctor will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different oophorectomy procedures and ask why your doctor will use a particular type for you.
Types of anesthesia that may be used
Your doctor will perform an oophorectomy using either general anesthesia or a nerve block.
General anesthesia is generally a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and do not feel any pain. You may also have a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of a liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control your pain during and after surgery.
Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your oophorectomy
The day of your surgery, you can generally expect to:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure that you understand and sign the surgical consent.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube will be placed in your windpipe to protect and control your breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout surgery and recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of an oophorectomy?
As with all surgeries, an oophorectomy involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding, which can lead to shock
Infection, which can spread to other areas
Potential complications of an oophorectomy
Complications of an oophorectomy can be serious and include:
Damage to nearby abdominal organs, such as the uterus or intestines
Development of an intestinal blockage
Oophorectomy results in early menopause. Menopause symptoms and complications include:
Anxiety and mood swings, which can interfere with your daily life and become debilitating
Higher risk of heart disease
Osteoporosis, or thinning bones
Sleep problems including insomnia or sleeplessness
Vaginal dryness, which cause burning, irritation, and painful sexual intercourse
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before, during and after surgery or treatment
Informing your doctor if you are nursing or there is any possibility that you may be pregnant
Losing weight if you are overweight. This will help keep you as healthy as possible and may reduce your risk of heart disease and of bone fractures.
Notifying your doctor immediately of any concerns after surgery, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage
Stopping smoking. This can help reduce the risk of osteoporosis and heart disease.
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my oophorectomy?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for an oophorectomy by:
Answering all questions about your medical history, allergies, and medications you take. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
Losing excess weight before the surgery through a healthy diet and exercise plan
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of the procedure because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. For an oophorectomy, this may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. You may also be instructed to take a laxative to clean out your bowel the day before surgery.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your preoperative appointments. Questions can include:
Why do I need an oophorectomy? Are there any other options for treating my condition?
What type of oophorectomy procedure will I need?
Will I be able to have children after I have the surgery?
How long will the procedure take? When can I go home?
What kind of restrictions will I have after the surgery? When can I return to work and other activities?
What kind of assistance will I need at home?
What medication plan should I follow before and after the surgery?
How will you manage my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my oophorectomy?
Knowing what to expect can help make your road to recovery after an oophorectomy as smooth as possible.
How long will it take to recover?
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
Minimally invasive oophorectomy typically involves a one- to two-night stay in the hospital. Open oophorectomy involves staying an additional night or two.
Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. Full recovery times range from a few weeks to a few months.
Will I feel pain?
Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it can be a sign of a complication.
When should I call my doctor?
It is important to keep your follow-up appointments after your surgery. Call your doctor if you have questions or concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Change in alertness, such as passing out, unresponsiveness, or confusion
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.
Inability to urinate or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Pain that is not controlled by your pain medication
Unexpected drainage, pus, redness or swelling of your incision
How might an oophorectomy affect my everyday life?
An oophorectomy may cure your condition or prevent you from having cancer at all. You will still need to have regular pelvic exams and possibly Pap tests after an oophorectomy.
An oophorectomy can also cause significant changes to your body that may affect your everyday life such as:
Early menopause. Symptoms of early menopause can be severe and include vaginal dryness, painful sexual intercourse, sleep problems, hot flashes, and mood swings. Hormone replacement therapy (estrogen and progesterone therapy) can treat early menopause.
Loss of childbearing ability. Some women report feeling a deep sense of loss after a bilateral oophorectomy, especially if they still planned to bear children. Tell your healthcare provider if you are concerned about these feelings.
Sexual changes. Some women report painful sex or a loss of orgasm during sex after an oophorectomy. See your healthcare provider if you have pain with intercourse or are not enjoying sex the way you did in the past.