Definition and Overview

Oophorectomy is a surgical procedure that removes one (unilateral oophorectomy) or both the ovaries (bilateral oophorectomy) that are located on the side of the uterus.

The ovaries are reproductive organs that contain the egg cells and are responsible for the hormones that control a woman’s menstrual cycle. When they are removed, the patient will lose her ability to bear children.

However, advances in the field of medicine paved the way for partial oophorectomy, which preserves the patient’s fertility by removing only the damaged or diseased tissues and keeping the healthy tissues intact.

Ovary removal procedures can be performed in conjunction with hysterectomy (uterus removal) or the removal of one or both the fallopian tubes.

Who Should Undergo and Expected Results

Oophorectomy is often recommended for female patients experiencing the following conditions:

  • Abscess in the fallopian tube and the ovary
  • Hereditary diseases of the female reproductive system. Some female patients have abnormal genes that put them at a higher risk of ovarian cancer. These patients can choose to undergo an ovary removal procedure to reduce the risk, especially if their mothers, sisters, and other close female relatives have had ovarian cancer.
  • Breast cancer. The hormones produced by the ovaries can increase breast cancer risk in some women. Removing the ovaries can be the solution for reducing the risk of both ovarian and breast cancers as it permanently halts the production of hormones that can cause the disease.
  • Ovarian torsion or the twisting of the ovary
  • Benign ovarian tumours or cysts that can cause problems for the patient’s general health
  • Endometriosis. This disease involves the growth of tissues normally found outside the uterus inside the organ itself. Patients typically experience pain in the pelvic area and some even become infertile. Pelvic pain typically occurs during menstrual cycles and sexual intercourse. Ovary removal eliminates the patient’s menstrual cycle, reduces the spread of the overgrowth of the uterine lining, and reduces pelvic pain. Patients with this condition can also elect for a hysterectomy in conjunction with oophorectomy.

    How is the Procedure Performed?

Before the procedure, the patient must consult with a qualified and experienced gynaecologist for pre-surgical preparations. She will then be advised to fast (limiting food intake and liquids) and drink a solution to empty the intestines a day before surgery. The surgeon might also order some imaging tests, including CT (computerized tomography) and ultrasound. General anaesthesia will be administered during this procedure.

The oophorectomy can be performed using two surgical approaches:

  • Traditional or open oophorectomy, which involves a single large incision made in the abdomen to gain access to the ovaries. The surgeon will then proceed by disconnecting the organs from the body’s blood supply. The tissues surrounding the ovaries will also be removed before the organs are lifted out of the body.

  • Laparoscopic oophorectomy, which involves three to four small incisions in the abdomen where the surgeon will insert a laparoscope, a tube-like instrument with a camera and light attached to one end, into one of the incisions. The camera attached to the laparoscope transmits live video, which the surgeon uses to guide the surgical tools to disconnect the ovaries from the body’s blood supply. The ovaries will be placed inside a pouch once they are ready for removal. The pouches containing the ovaries will then be pulled out of the patient’s body through one of the incisions.

Laparoscopic oophorectomy offers the advantage of shorter recovery time, minimal surgical pain, and shorter hospital stay.

Possible Risks and Complications

Ovary removal is only recommended when its benefits greatly outweigh the risks involved. Over the years, research shows that some serious and irreversible risks and complications can be experienced by a patient who underwent oophorectomy, including the following:

  • Surgical risks, such as bleeding, perforation of nearby reproductive structures, infections, and bowel obstruction
  • Premature death
  • Cardiovascular disease
  • Dementia or cognitive impairment
  • Osteoporosis and bone fractures
  • Psychological health issues
  • Sexual function issues
  • Parkinsonism
  • Infertility or reduced fertility
  • Surgical (premature) menopause
  • Low estrogen and progesterone production

Regular consultation with an OB-GYN will be required after the patient has had her ovaries removed both for non-hormonal and hormonal treatments that can improve her general health.

References:

  • Hoffman BL, et al. Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. ttp://accessmedicine.com/resourceTOC.aspx?resourceID=768.

  • DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology. 11th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=788.

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