Why Is Salpingo-Oophorectomy Done?
Doctors may usually consider a salpingo-oophorectomy for the pathology involving the woman’s reproductive organs. It is an approach used if other less invasive alternatives have been ineffective or failed.
Salpingo-oophorectomy is the procedure done to remove the ovaries and fallopian tubes in
- Patients to prevent ovarian cancer if they have any inherited cancer gene. This is called a prophylactic salpingo-oophorectomy.
- Women who are diagnosed with breast cancer. Most breast cancers are hormone-dependent. Removing the ovaries drastically reduces estrogen production in the body. This may help shrink tumors, prevent the spread, and lower the chances of reoccurrence of hormone-dependent cancer.
- Patients with endometriosis. In this condition, the uterine tissue proliferates in the uterine tubes or other parts of the uterus causing severe menstrual pain, low back and pelvic pain, and abnormal vaginal bleeding.
This procedure is also recommended in patients with:
- Non-cancerous ovarian tumors.
- Ovarian cysts.
- Ovarian abscesses or infection (post-menopause women).
- Twisted ovaries.
- Pelvic infections.
- Ectopic pregnancy (when a fertilized egg grows outside a woman's uterus).
If one fallopian tube is removed with one ovary, the surgery is a unilateral salpingo-oophorectomy. If both the fallopian tubes are removed with both the ovaries, it is a bilateral salpingo-oophorectomy.
How is salpingo-oophorectomy performed?
The doctor may perform salpingo-oophorectomy under general or regional anesthesia. Below are common surgical approaches:
- Open abdominal oophorectomy: It involves removal of the ovaries and fallopian tubes through a five- to seven-inch cut in the lower part of the belly. The cut may be vertical or horizontal. Open surgery allows the doctor to directly see and access the surgical area; however, it involves a longer recovery period and more pain. Open surgery requires a larger cut and more displacement of the muscles and other tissues. Despite this, open surgery may be a safer or more effective method for certain patients.
- Laparoscopic oophorectomy: It involves the removal of the ovaries and fallopian tubes through several small incisions in the abdomen. Usually, the 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. The doctor sees the inside of your abdomen on the screen while performing the surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. A vaginal approach can also be performed, especially when combined with removing the uterus.
- Robotic approach: Robotic salpingo-oophorectomy is a similar procedure to laparoscopic salpingo-oophorectomy. During robotic salpingo-oophorectomy, a robotic arm, operated by an experienced gynecological surgeon, will be used to locate and remove the ovaries and fallopian tubes.
The doctor may advise which procedure is the best based on a patient’s diagnosis, age, medical history, general health, and possibly personal preference.
What are the risks involved in a salpingo-oophorectomy procedure?
Common risks involved in salpingo-oophorectomy include:
- Anesthesia reaction, such as an allergic reaction, dizziness, headache, or vomiting
- Excessive bleeding
- A blood clot, in particular, deep vein thrombosis (DVT) that develops in the leg or pelvis (a DVT can travel to your lungs and cause pulmonary embolism)
- Infection, which can spread to other areas
- Damage to the nearby abdominal organs, such as the uterus or intestines
- Development of 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
- Hot flashes and night sweats, which are often described as a sudden sensation of warmth, flushing, and sweating
- Osteoporosis or thinning bones
- Sleep problems including insomnia or sleeplessness
- Vaginal dryness, which causes burning, irritation, and painful sexual intercourse
What is the recovery period after a salpingo-oophorectomy procedure?
The recovery period after salpingo-oophorectomy depends on the type of procedure.
Laparoscopic or robotic salpingo-oophorectomy may be performed on an outpatient basis, and patients may go home on the same night. Some patients with laparoscopic or robotic salpingo-oophorectomy will need an overnight hospital stay. It can take approximately three weeks to return to the normal activity level after laparoscopic or robotic salpingo-oophorectomy.
In open salpingo-oophorectomy, patients may need to recover in the hospital for a few days after the surgery. It can take up to eight weeks to return to the normal activity level after open salpingo-oophorectomy.