Oophorectomy is a highly recommended surgery that is used for curing a number of ovarian conditions. Read on to know what Oophorectomy is, how it is performed and its various uses.
Oophorectomy Definition
Medical researchers define Oophorectomy as a surgical process that involves removal of one ovary or both ovaries. This operative procedure is also known by other names like Ovarian Ablation or Ovariectomy.
Picture 1 – Oophorectomy
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Why Is Oophorectomy Conducted?
This surgery is conducted for a number of reasons like
- Removing cancerous ovaries
- Removing an abscess
- Removing large ovarian cysts in patients of Polycystic Ovarian Syndrome (PCOS)
- Curing endometriosis
- Lower the risk of ovarian cancer in women with a family history of the disease
- Reduce the risk of an ectopic pregnancy
- Treating cancerous conditions of the ovary and preventing their spread to other organs
- Removing the source of estrogen that brings on ovarian cancer
Oophorectomy Procedure
Usually, individuals who have to undergo this operation have to go through urine and blood tests. Additional tests like Rays or Ultrasound may also be recommended by doctors. These help surgeon visualize the condition of the patient. The sufferer may also require a session with an anesthesiologist who can evaluate any specific disorders that may affect her health on administration of anesthesia. In case an extensive surgery is expected, a colon preparation may be made.
Generally, women have to eat a light dinner in the evening before surgery. There should not be any oral intake of other substances after midnight. This includes solid foods as well as water or any other fluid.
The operation is carried out under the effects of general anesthesia. It is performed either through vertical or horizontal incision, as an abdominal hysterectomy. Once the incision is made, the muscles of the abdomen are pulled apart to give surgeons a clearer view of the abdominal cavity. This is followed by the removal of the ovaries and frequently, the fallopian tubes.
Laparoscopic Oophorectomy
Sometimes, Oophorectomy can be carried out with the aid of laparoscopy. A Laparoscopic Oophorectomy involves insertion of a tubular instrument known as laparoscope that consists of a light source and a tiny lens. A small incision is made in the surface of the navel and the tube is inserted through it. This apparatus also contains a monitor that sends a clear image of the abdominal cavity to a video monitor. The ovaries, once separated, can be removed though a tiny incision at the upper surface of the vagina. The ovaries may also be removed in an easier manner by cutting them into smaller sections.
Women undergoing this surgery may experience some discomfort in the post-operative stage. The level of discomfort may vary from person to person. However, these are seen to arise most in women with abdominal incisions. This is because in case of an abdominal incision, the abdominal muscles are excessively stretched to allow surgeons reach the ovaries.
You can take a look at this Laparoscopic Oophorectomy video to know about this surgical method in pictorial detail.
Post-Oophorectomy Care
After removal of both ovaries, Hormone Replacement Therapy may be used for women who are not suffering from cancer. This can help alleviate menopausal symptoms that arise due to absence of estrogen produced by the ovaries. If even a part of one ovary remains, enough estrogen may be produced to keep menstruation continue unabated. However, this is not possible if the woman has her entire uterus removed through a hysterectomy.
Antibiotic drugs may be used to lower any mischance of post-operative infection.
Pregnancy after Oophorectomy
If one ovary is excised, menstruation may continue unabated in a woman and she can have children. If both ovaries are surgically removed, menstruation can stop with the patient losing the ability to have babies. A unilateral Oophorectomy can make it possible for women to have babies. However, a bilateral Oophorectomy makes this impossible.
Oophorectomy Recovery
In case of a successful surgery, no complications arise after removal of ovaries. The underlying problem can be brought to a resolution. In the case of individuals having cancer, all cancerous lumps can be successfully removed.
In patients undergoing this surgery require anywhere from 2-6 weeks to get back to normal activities. However, recovery period may actually depend on the type of Oophorectomy surgery. When women suffer from cancerous conditions, radiation or chemotherapy is often used in addition to operation. Some women suffer a mental trauma after an Oophorectomy. Support groups and counseling can benefit individuals regain their mental stability.
Oophorectomy Side Effects
This surgical procedure involves a few side effects. These include
Post-surgical infection
If the surgery is not conducted with proper care, it may give rise to bacterial infection in the post-operative stages. It is for this reason that patients require antibiotics after completion of surgery.
Post-operative scars
This operation gives rise to scars in the abdomen. Vertical incisions leave a more prominent scar than Horizontal incisions. However, they are favored due to the fact that they provide surgeons with a better view of the abdomen cavity.
Some other side effects include internal bleeding, unforeseen reaction to anesthesia, accidental damage to other organs and development of blood clots.
Oophorectomy Complications
This surgery may give rise to complications if cancer is found to have spread to other areas in the abdomen. If surgical process is unable to cure cancer, radiation and chemotherapy may be used for treatment. In about 18% of all women suffering from acute endometriosis, a complicated condition known as Ovarian Remnant Syndrome may arise after Oophorectomy surgery. This condition is characterized by development of a pelvic mass and/or a chronic pelvic pain. This is usually cured by further surgery that aims at removing the remaining ovarian tissue.
Post- Oophorectomy complications may also include hot flashes and changes in sex drive. Removal of both ovaries may also give rise to other menopausal symptoms. It may also increase the risk for osteoporosis and cardiovascular disease in women who do not undergo Estrogen Replacement Therapy. Women who have a history of emotional and psychological problems can suffer from more mental difficulties after the surgery.
Salpingo-Oophorectomy
It is a variation of Oophorectomy that involves removal of both the fallopian tube and the ovary of a woman. It is differentiated into two types.
Unilateral Salpingo-Oophorectomy
It includes surgical removal of one ovary and one fallopian tube. The name Salpingo-Oophorectomy also refers to a Unilateral Salpingo-Oophorectomy Surgery.
This operation is possible for certain young women who suffer from some early-stage forms of ovarian cancer. Removal of only one ovary may help women bear children in their future.
Bilateral Salpingo-Oophorectomy
It involves both sets of fallopian tube and ovary. This operation mainly aims at curing cancerous conditions of organs like fallopian tubes, uterus and ovary.
This operation results in premature menopause and infertility for many women who are menstruating until now.
Hysterosalpingo-Oophorectomy
It is a complicated operation that involves surgical removal of the ovaries, the oviducts and the uterus. Sometimes, this operation becomes necessary after use of certain medications like Avonex that is used to cure problems like Multiple Sclerosis. Ectopic Pregnancy may also be an associated symptom.
Bilateral Hysterosalpingo-Oophorectomy
Also known as Radial Hysterectomy, this operative procedure is most commonly used to cure uterine cancer. It involves surgical removal of the fallopian tubes, ovaries, uterus, cervix and the lymph nodes that are located nearby. If the operation is conducted before natural menopause, it can give rise to surgical menopause in patients.
Prophylactic Oophorectomy
This operation is used to remove the ovaries surgically. It helps prevent cancer of the breasts or the ovaries that may arise as a result of mutations in the BRCA1 or BRCA2 genes. Ovaries are also removed to reduce the amount of the progesterone and estrogen hormones circulating in the body. Reduction of these hormones in the body can slow down or stop formation of breast cancers that grow with the aid of these hormones.
Left Salpingo-Oophorectomy
This surgical process is also known as LSO or simply as Left Oophorectomy. It is used to treat problems like Ovarian Endometriosis. The surgery involves removal of the left ovary of patients.
Right Salpingo Oophorectomy
It involves removal of the right ovary of patients. This operative procedure is abbreviated as RSO. It is also referred to as Right Oophorectomy. The surgery can be helpful in curing problems like lysis of pelvic adhesions.
Hysterectomy and Oophorectomy
Hysterectomy is a surgical process involving excision of the uterus. But Oophorectomy includes surgical removal of the ovaries. It leads to surgical menopause. Sometimes, a hysterectomy can involve an Oophorectomy. This occurs in cases where one or both ovaries of a woman are surgically removed. These surgical procedures may also occur singly.
Post-operative recovery may depend on whether both these processes have been performed and also whether the process had been carried out through laparoscopic means.
Partial Oophorectomy
It is a term that is used in some cases to depict a diverse variety of operative procedures such as resection of ovarian parts or ovarian cyst removal. This type of surgery helps preserve fertility although an ovarian failure may arise as a common side effect. Almost all of the consequences and long term risks of oophorectomy are absent or present only partially with Partial Oophorectomy.
Oophorectomy after Menopause
If this surgery is performed before menopause, the risk of having breast cancer can decrease in women with a family history of the condition. However, this operation can result in early menopause. For this reason, women require counseling about the menopausal symptoms that they are likely to experience. However, this operation is less likely to give rise to fresh menopausal symptoms in post-menopausal women. This is because production of endogenous androgen slumps following spontaneous menopause as well as after use of Oophorectomy.
Oophorectomy and Salpingectomy
An Oophorectomy is a surgical procedure to remove one or both of the ovaries. A salpingectomy is a surgical procedure to remove one or both of the Fallopian tubes. Salpingectomy is usually combined with an oophorectomy (removal of one or both ovaries), hysterectomy (removal of the uterus), and omentectomy (removal of the omentum) to treat patients with ovarian cancer. All of these procedures are typically performed under general anesthesia. A salpingectomy alone is associated with a short recovery time.
Oophorectomy and Breast Cancer
Prophylactic Oophorectomy is regarded as an effective surgery for prevention of breast cancer. As aforesaid, this operation consists of surgical removal of the ovaries. This operative procedure is usually reserved for patients who have a high risk of developing breast cancer. This procedure is considered most appropriate for women aged around 35 and above, who have given birth to one or more offspring. In women above 40 years of age and with high risk of BRCA2 mutations, Oophorectomy has been found to increase chances of survival on a marginal basis. It is quite effective in curing cancerous conditions of the breast and the ovaries.
This surgical method was first used in 1872 by a German surgeon named Alfred Hegar while curing a benign condition. But it was George Thomas Beatson who was credited to be the first surgeon to use this operation for breast cancer in 1895.
Oophorectomy and Ovarian Cysts
This surgical procedure is often used as a last resort for patients suffering from ovarian cysts. The surgery can be unilateral or bilateral depending on whether the cysts have developed on right or left ovary or both. Traditionally, gynecologists recommend both Oophorectomy (removal of both ovaries) and Hysterectomy in case of patients above 40 years of age.
Oophorectomy Pain
Following this surgery, many women complain of pain in the lower back region. The degree of pain and discomfort varies from person to person. It is usually the greatest in case of abdominal incision as it requires overstretching of the abdominal muscles to let surgeons reach the ovaries. The pain is usually less in women undergoing a laparoscopic method than an abdominal incision procedure.
Constant back pain or scanty or bloody urine can indicate injury of the ureter during surgery. Many individuals also complain of severe nerve pain in the back and the leg. Patients should immediately get in touch with a doctor in such cases.