Oophorectomy is a surgical procedure that involves the removal of one or both ovaries. The ovaries are the female reproductive organs that produce eggs and hormones, such as estrogen and progesterone. Among the reasons for oophorectomy are ovarian cancer, benign ovarian tumors, endometriosis, ovarian cysts, or chronic pelvic pain. Women with a genetic mutation or a strong family history of ovarian or breast cancer may also benefit from oophorectomy.
The major cause of oophorectomy is ovarian cancer, the fifth most common cancer among women and the most lethal gynecologic cancer. One or both ovaries can be affected by ovarian cancer, and it may spread to other organs, including the fallopian tubes, the uterus, the lymph nodes, or the abdomen. Symptoms of ovarian cancer include abdominal pain, bloating, swelling, weight loss, irregular periods, and vaginal bleeding. Depending on the stage and type of cancer, ovarian cancer can be diagnosed through physical examinations, pelvic ultrasounds, blood tests, or biopsies. Treatment options include surgery, chemotherapy, radiation, or targeted therapy.
Oophorectomy may also be performed for the following reasons:
The benign growths of the ovary, such as cystadenomas, dermoid cysts, or fibromas, can cause pain, pressure, or bleeding.
In endometriosis, the uterine lining grows outside the uterus, such as on the ovaries, causing pain, inflammation, and infertility
Cysts can form on or in the ovaries, causing pain, swelling, or hormonal imbalances
Inflammations, adhesions, and nerve damage may cause chronic pelvic pain, which is a persistent or recurrent pain in the lower abdomen or pelvis.
For women who are at high risk of developing ovarian or breast cancer as a result of a genetic mutation, such as BRCA1 or BRCA2, or a strong family history of these cancers, risk reduction is an important preventive measure.
In addition to the reason for the surgery, the type of surgery, and the individual response of the patient, oophorectomy symptoms can include:
It may be relieved by painkillers, ice packs, or heating pads if there is pain or discomfort in the abdomen or pelvis
Vaginal bleeding or spotting, which may last a few days or weeks and require pads or tampons
Wearing loose clothing or a supportive garment may reduce swelling or bruising in the abdomen or pelvis within a few weeks
Antibiotics or anti-inflammatory drugs may be needed if there is infection or inflammation at the surgical site, which can cause fever, redness, swelling, or pus.
As a result of the removal of both ovaries, hormonal changes may occur, which result in menopause, which is the permanent cessation of periods and fertility. Hot flashes, night sweats, mood swings, insomnia, vaginal dryness, osteoporosis, and mood swings are some of the symptoms of menopause. In order to manage hormonal changes, hormone replacement therapy (HRT) is used, which replaces estrogen and progesterone that are no longer produced by the ovaries. There are some benefits to HRT, including relieving the symptoms of menopause, preventing bone loss, and reducing colon cancer risk. It should be used with caution and under the supervision of a physician because HRT can increase the risk of blood clots, stroke, heart disease, or breast cancer.
An oophorectomy can be diagnosed based on a number of factors, including a medical history, a physical examination, and imaging tests. Doctors will ask about the patient's symptoms, medical history, and family history. Additionally, the doctor will perform a pelvic examination to detect abnormalities, such as masses, cysts, and tenderness, as well as the size, shape, and position of the ovaries. An ultrasound, CT scan, or MRI can provide a detailed view of the ovaries and surrounding organs, and confirm the diagnosis of the condition that requires surgery.
Depending on the reason for the surgery, the condition of the patient, and the doctor's preference, oophorectomy can be treated in different ways.
The unilateral oophorectomy preserves the patient's menstrual cycle and fertility, and is used for benign ovarian tumors, cysts, or endometriosis.
A bilateral oophorectomy, which removes both ovaries, causes menopause and fertility loss, and can be performed for ovarian cancer, risk reduction, or chronic pelvic pain.
Salpingooophorectomy involves removing both or one of the ovaries along with the fallopian tubes, which connect the ovaries to the uterus. For ovarian cancer, risk reduction, or endometriosis, this type of oophorectomy can affect the menstrual cycle and fertility of the patient.
One or both ovaries are removed along with the uterus, which is the organ responsible for nourishing and storing the fetus during pregnancy. Menopause and fertility loss can occur as a result of this type of oophorectomy, which may be performed to treat ovarian cancer, uterine cancer, endometrial cancer, or uterine fibroids.
A variety of surgical techniques can be used to perform an oophorectomy, including:
The laparotomy is a traditional open surgery in which the ovaries are removed through an incision in the abdomen. For large or complex oophorectomies, laparotomies can provide a clear view of the organs. In addition to causing more pain, bleeding, scarring, and infection, laparotomy may also require a longer hospital stay and recovery time.
During laparoscopic surgery, several small incisions are made in the abdomen, and a thin tube with a camera and light (laparoscope) and other surgical instruments are inserted. A laparoscope can show images of the organs on a monitor, and guide the removal of the ovaries. In addition to causing less pain, bleeding, scarring, and infection, laparoscopy may have a shorter recovery period. In patients with adhesions or previous abdominal surgeries, laparoscopy may not be appropriate for large or complex oophorectomies.
During robotic surgery, a robotic system is used to control the laparoscope and surgical instruments more precisely and moreflexibly than a conventional laparoscope. There are some advantages to robotic surgery over conventional laparoscopy, including better visualization, magnification, and dexterity. It is possible, however, that robotic surgery may also carry some disadvantages, such as higher cost, longer operating times, or limited availability.
It is not always possible to prevent oophorectomy, but you can reduce your risk by following some preventive measures, such as:
Regular pelvic exams and pap smears to detect ovarian cancer and other gynecologic conditions
A genetic test and counseling if you have a family history of ovarian or breast cancer or a genetic mutation that increases your risk
By suppressing ovulation and reducing hormone exposure to the ovaries, oral contraceptives reduce the risk of ovarian cancer
Avoiding smoking, alcohol, and obesity, which can increase your risk of ovarian cancer
It is important to seek medical attention immediately if you experience any symptoms of ovarian cancer or other gynecological conditions, such as abdominal pain, bloating, swelling, weight loss, irregular periods, or vaginal bleeding.
