Patient education: Oophorectomy (The Basics)

What is oophorectomy? — Oophorectomy is surgery to remove the ovaries. The ovaries are part of the reproductive system (figure 1). If you have monthly periods, your ovaries release an egg about once a month.

Both ovaries can be removed, or just 1. Or, in some cases, doctors might remove just part of an ovary. This is called "cystectomy."

Removing both ovaries means that you will go through menopause, if you haven't already. This means that your monthly periods will stop. After this, you will not be able to get pregnant, unless you remove and freeze your eggs or use donor eggs.

Oophorectomy can be done in 2 ways:

●Open surgery – During an open surgery, the doctor makes a cut, or "incision," in the skin. This allows them to see directly inside the body when they do the surgery.

●Minimally invasive surgery – "Minimally invasive" surgery allows the doctor to make smaller cuts in the skin. They insert long, thin tools through the cuts. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (this is called "robot-assisted" surgery).

You might be able to return to normal activities sooner if you had minimally invasive surgery than if you had an open surgery.

Sometimes, oophorectomy is done at the same time as other procedures. These include:

●Hysterectomy – This is surgery to remove the uterus.

●Salpingectomy – This is surgery to remove the fallopian tubes. When the fallopian tubes and ovaries are removed at the same time, this is called a "salpingo-oophorectomy."

How do I prepare for oophorectomy? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Imaging tests – Imaging tests create pictures of the inside of the body.

●Lab tests

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

●Any family history of ovarian or breast cancers

You will also get information about:

●Eating and drinking before your procedure – In most cases, you will need to "fast" before surgery. This means not eating or drinking anything for a period of time. Whether you need to fast, and for how long, depends on the procedure you are having.

●Lowering the risk of infection – In some cases, you might need to trim (not shave) your body hair before your procedure. You might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during oophorectomy? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●You might get medicines to help control pain after the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●If you are having open surgery:

•The doctor will make an incision in your belly area.

●If you are having minimally invasive surgery:

•The doctor will make a few small incisions in your belly area.

•Gas will be put into your belly. This makes it easier for the doctor to move the laparoscope and tools around.

•The doctor will insert the laparoscope through 1 of the cuts so they can see inside your body.

•The doctor will also insert long, thin tools to do the surgery. If you are having robot-assisted surgery, the doctor will use a surgical robot to control the tools.

●The doctor will remove 1 or both ovaries. In some cases, they will only remove part of an ovary.

●The doctor will close your incisions and cover them with clean bandages.

What happens after oophorectomy? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine to help with pain, if needed. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of oophorectomy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●Damage to nearby organs

●"Spillage" of cancer cells – If a cancerous tumor is damaged while being removed during surgery, some of the cancer cells might spill out and stay in the body.

●Ovarian remnant syndrome – This is when some ovary tissue is left in the body after surgery. This can cause problems and might mean that you need to have more surgery.

What else should I know?

●It is normal to have some light vaginal bleeding or spotting after an oophorectomy.

●If you have not yet gone through menopause (when monthly periods stop), having both ovaries removed will cause "surgical menopause." This is when menopause happens earlier than normal. Other symptoms of menopause can include:

•Hot flashes or night sweats

•Low mood

•Vaginal dryness

•Trouble falling or staying asleep

•Trouble concentrating or remembering things

•Weak bones

There are treatments that can help relieve these symptoms.

●If you have both of your ovaries removed, it will not be possible to get pregnant on your own. In some cases, if you want to be able to carry a pregnancy in the future, there might be ways to plan ahead for this. For example, you might be able to freeze your eggs before the surgery or use "donor" eggs.

More on this topic

Patient education: Oophorectomy – Discharge instructions (The Basics)
Patient education: What you should know about oophorectomy (The Basics)
Patient education: Ovarian cancer (The Basics)
Patient education: Ovarian cysts (The Basics)
Patient education: Endometriosis (The Basics)
Patient education: Hysterectomy (The Basics)
Patient education: Preserving fertility after cancer treatment in women (The Basics)
Patient education: Female infertility (The Basics)
Patient education: Menopause (The Basics)

Patient education: Ovarian cancer diagnosis and staging (Beyond the Basics)
Patient education: Treatment of ovarian cancer (Beyond the Basics)
Patient education: Ovarian cysts (Beyond the Basics)
Patient education: Endometriosis (Beyond the Basics)
Patient education: Abdominal hysterectomy (Beyond the Basics)
Patient education: Menopause (Beyond the Basics)
Patient education: Menopausal hormone therapy (Beyond the Basics)