Surgical Procedures: Oophorectomy

What is an oophorectomy and how is it performed?

An oophorectomy is a surgery that takes out the ovaries. The ovaries are the two almond-shaped organs that hold and release eggs for ovulation. They also make hormones. This surgery can be done alone or with a hysterectomy.

The types of oophorectomy are:

• Unilateral oophorectomy: Taking out one ovary.
• Bilateral oophorectomy: Taking out both ovaries.
• Salpingectomy: Taking out the fallopian tube(s).
• Partial oophorectomy: Taking out part of one or both ovaries.
• Unilateral salpingo-oophorectomy: Taking out one ovary and fallopian tube.
• Bilateral salpingo-oophorectomy: Taking out both ovaries and their fallopian tubes.

Getting an oophorectomy can lower the risk of breast and/or ovarian cancers in women who are at a higher-than-normal risk. A prophylactic oophorectomy is a surgery done before cancer starts.

Oophorectomy can treat:

• Ovarian cancer.
• Endometriosis.
• Pelvic pain.
• Pelvic inflammatory disease.
• Tubo-ovarian abscess.
• Non-cancerous ovarian cysts.
• Ovarian torsion.

There are many ways of doing an oophorectomy. The type used is based on your situation.

Surgical approaches are:

• Open abdominal surgery: An incision is made into the belly to remove the ovaries.
• Laparoscopic procedure: Many small incisions are made. A laparoscope, a lighted tube with a camera, is placed into one of these incisions. The ovaries will be removed through one of the small incisions in the abdomen.
• Robotic Surgery: The surgeon uses a robotic arm to do the surgery through small incisions.

If you want to keep your fertility, talk about your choices with your healthcare team. You may be able to keep one of the two ovaries, which in many cases natural conception can happen. If both of the ovaries are being removed, you should talk with a fertility specialist about your choices before having the surgery.

What are the risks of having an oophorectomy?

If both ovaries are removed, menopause will start, and you may have side effects such as hot flashes and vaginal dryness. Your risk of getting osteoporosis, heart disease, and premature death is greater once menopause starts due to ovary removal. Also, you may have depression, anxiety, memory issues, and decreased libido.

What are the risks of having an oophorectomy?

There are risks and side effects of having an oophorectomy. Risks and side effects may be:

• Bleeding.
• Blood clots.
• Reaction to anesthesia. (Anesthesia is the medication you are given to help you sleep through the surgery, not remember it, and to help with pain. Reactions are wheezing, rash, swelling, and low blood pressure.)
• Nerve damage.
• Infection.
• Hernia.
• Scar tissue.
• Injury to the urinary tract and/or surrounding organs.
• Bowel obstruction (block).

What is recovery like?

You may have to stay in the hospital. Early walking and deep breathing can help prevent blood clots and pneumonia.

Your medical team will discuss with you the medications you will be taking for blood clot, infection, pain, and constipation prevention.

If you had a laparoscopic oophorectomy you may have shoulder pain. This is a normal side effect and should go away within 1-2 days.

Your provider will tell you what you should and should not do when you go home. This will often include:

• Get plenty of rest.
• Avoid heavy lifting.
• No tub bathing, sexual intercourse or anything in the vagina (tampons, douching, etc) until instructed by your healthcare provider. Bloody to light vaginal discharge is normal.
• Use stairs as tolerated.
• Do not drive while taking narcotic pain medication.
• If you have constipation, you can make changes to your diet, increase your fluid intake, and take over-the-counter medication. Straining to have a bowel movement should be avoided.
• Ask your provider if you should avoid taking aspirin as it may cause bleeding.

What will I need at home?

• A thermometer to check for fever, which can be a sign of infection.
• Loose clothes and underwear.
• Incision care items, often times supplied by the hospital/physician office.
• Sanitary pads for vaginal bleeding/discharge.

Care of incision

Laparoscopic Incision Care:

Your small incisions will be closed with stitches or a special glue. The incisions will be covered with bandages which can be removed in 24 hours. The stitches do not need to be removed and they will dissolve over time. Keep the incision clean and dry.

Open Abdominal Incision Care:

Incisions should be kept clean and dry. Avoid tub bathing for at least 4 weeks or until your healthcare provider instructs otherwise. Showering is advised, but you should not scrub the incision. Allow the water to run over the incision with a mild soap and pat dry.

At times, drains may be left in place, making careful attention to gentle drying important. If staples are present, they will be removed at your post-operative visit (approx. 10-14 days following surgery) at which time steri-strips (special tape) will be placed. It is ok to shower with either staples or steri-strips. Wear loose fitting clothes to avoid irritating the incision. Avoid sun exposure to the incision. Do not use lotions or ointments to your incision unless instructed by your healthcare team. For both laparoscopic and open abdominal incisions, be sure to look for signs of infection including redness, swelling, drainage, or separation (opening) of the incision, and report these to your provider.

When to Contact Your Care Team

• Fever. Your care team will tell you at what temperature they should be contacted.
• Shortness of breath
• New or worsening pain.
• Heavy vaginal bleeding.
• Foul-smelling vaginal discharge.
• Nausea/vomiting.
• Trouble urinating.
• Mood swings.
• Depression.

How can I care for myself?

You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that you can go back to your normal activity.

Be sure to take your prescribed medications as directed to prevent pain, infection, and/or constipation. Call your team with any new or worsening symptoms.

There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and help drain lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

• Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.