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Ovarian Surgery

Ovarian surgery involves doing a procedure on the ovaries that can include removal of an ovarian cyst, removal of the ovary due to cancer and surgery that is not related to cancer, such as treatment of the ovary due to endometriosis. An oophorectomy is when an entire ovary is removed for a variety of reasons.

In an oophorectomy, one or both of the ovaries are removed. The ovaries are about the shape and size of a ping pong ball and are attached to the Fallopian tubes on either side of the pelvis. They contain the female eggs that ideally ovulate each month to release a mature egg into the Fallopian tubes. Ovaries also contain the female hormones used throughout a woman’s lifetime.

An oophorectomy can be done as an isolated procedure but is usually done along with removal of the uterus (hysterectomy) and removal of the fallopian tubes. This is called a total hysterectomy. When the tubes and ovaries are just taken together, the procedure is called a salpingo-oophorectomy. When one ovary is removed, it’s called a unilateral oophorectomy; if both are removed, it’s called a bilateral oophorectomy.

Why would one have an ovary removed? There are several reasons why this procedure might have to be done. These include the following:

  • Ovarian cancer: In such cases the entire ovary is removed and sometimes the whole uterus and both ovaries.
  • Endometriosis. This is when uterine lining travels outside the uterus and settles on the ovaries, the fallopian tubes, outside the uterus and on pelvic tissue.
  • Benign or noncancerous cysts or tumours on the ovary.
  • As a prophylactic measure to prevent a woman from getting breast cancer or ovarian cancer if they happen to have an increased risk.
  • The condition called ovarian torsion. This is when the ovary twists and cuts off its blood supply. It can become necrotic and require removal of the ovary.
  • A tubo-ovarian abscess: in such cases, there are bacteria and pus collected between the fallopian tube and the ovary. Both must be removed in order to clear the infection. It is often related to a sexually transmitted disease.

The ovary can be done alone or in connection with other pelvic procedures. For example, in a tubo-ovarian abscess, the tube and ovary are removed together. In a total hysterectomy, the ovary is removed along with the entirety of the fallopian tubes and ovaries. A salpingo-oophorectomy is done whenever a woman is at risk for ovarian cancer and has her ovaries removed prophylactically. This increased risk can be determined through genetic testing and family history.

There are risks to having an oophorectomy and the risk increases if it is done along with a hysterectomy or salpingectomy (tube removal). The major risks include:

  • Getting a postoperative infection.
  • Having bleeding at the time of surgery.
  • Accidentally damaging organs near the ovary.
  • Tumor rupture which has the potential to spread cancer cells throughout the pelvis.
  • Failure to get all the ovarian cells, leading to ongoing pain and other pelvic symptoms.

There is also a risk of causing premature menopause, especially if most or all of both ovaries are removed. If this happens, the lack of the ovarian hormones can cause the following:

  • Hot flashes and vaginal dryness—signs and symptoms of menopause.
  • Heart disease.
  • Anxiety or depression.
  • Problems with memory.
  • Osteoporosis.
  • Lessened sex drive.
  • Early death from heart disease.

Hormone replacement medications may be taken after an oophorectomy. It has its own risks but can be taken before the age of fifty. You need time to recover after the surgery. If you are healthy, you can return to your normal activities at about six weeks post-surgery. If your surgery was laparoscopic, you will likely recover sooner—about two weeks following the surgery.

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