Oophorectomy

What Is an Oophorectomy?

An oophorectomy is a surgical procedure in which one or both ovaries are removed to treat ovarian issues like ovarian cysts and malignant tumors. Named a unilateral oophorectomy or bilateral oophorectomy, respectively, it’s an effective approach to reduce the risk of cancer in women.

Depending on the condition being treated, and your overall health, oophorectomy can be performed through different techniques, such as:

• Laparoscopic oophorectomy, which is a minimally invasive procedure that requires three to four small incisions in the abdomen
• Open oophorectomy, an option that’s considered when conditions are complex; incisions are large and made in the lower abdomen
• Vaginal oophorectomy, which is less common and is used if ovaries are accessible through the vaginal canal, performed often with vaginal hysterectomy.

You may get a salpingo-oophorectomy where one ovary and one fallopian tube or both ovaries and both fallopian tubes are removed. Unilateral salpingo is used to preserve fertility and to treat ectopic pregnancies. You may require a bilateral salpingo to treat ovarian cancer. Women with severe endometriosis often are recommended to undergo salpingo-oophorectomy.

The technique varies for each case, so you should only rely on an experienced surgical gynecologist. Dr Felix Cohen, founder and director of Cohen Medical Practice in NYC specializes in gynecological surgeries. His training makes him your top choice if you need guidance for reproductive issues of all kinds.

Why I Might Need an Oophorectomy?

Most of the time an oophorectomy is recommended for ovarian cysts that are large, persistent and causing pain. In such cases removing the affected ovary becomes necessary.
However, you might get this surgery for other conditions such as:

• Having BRCA1 or BRCA2 gene mutation
• Polycystic ovarian syndrome
• Masses in the area around your uterus
• Pelvic inflammatory disease
• Chronic pelvic pain

Your doctor may prefer not to do an oophorectomy if you want to preserve your ovarian functions and conceive in the future. If your pain and bleeding are manageable or you’re at high risk for surgical complications and have conditions like hypothyroidism or hyperprolactinemia, you may have to drop the idea of oophorectomy.

How Is an Oophorectomy Performed?

Before scheduling for an oophorectomy, you get relevant blood tests, urine tests, and imaging tests. You receive general anesthesia to make sure you don’t feel any pain.

The procedure then includes:

1. Making a small incision, either through a laparoscope or through a larger incision
2. Using specialized, sanitized instruments to remove the affected ovary or both ovaries
3. Closing the incisions with stiches or staples

Usually, laparoscopic oophorectomy takes about one to two hours, whereas an open surgery takes closer to three hours. Full recovery may take four to six weeks following a full laparotomy and one to two weeks after a laparoscopic procedure. You may feel mild pain that’s manageable with over-the-counter medication.

How Long Does Surgical Menopause Last and What Happens Afterward?

If both your ovaries are removed, you need to start menopause care, as removal eliminates both estrogen and progesterone hormones. This leads to the sudden onset of menopause, also known as surgical menopause. Just as if you passed perimenopause, you may experience mood changes, hot flashes or vaginal dryness.

Symptoms vary and may:

• Last for months or years
• Come and go in short episodes
• Respond well to hormone replacement therapy (HRT)

An oophorectomy after breast cancer is beneficial if you have hormone-receptor-positive breast cancer. Estrogen speeds up the growth of certain types of breast cancer, so removing the ovaries reduces estrogen, lowering the risk of dying from cancer. Premenopausal women still produce estrogen, so an oophorectomy reduces your risk factors as well if you develop this type of breast cancer.

After the surgery, you might experience some pain and discomfort at the incision site, so your surgeon prescribes pain meds for that.

Other post-surgical instructions include:

• Resting in the first week as you slowly return to your normal routine
• Keeping the incision dry and clean, avoiding dipping the area in water until it’s healed
• Calling your CMP surgeon immediately if you see signs of infection or swelling in the leg

How Can I Reduce Risks and Side Effects of an Oophorectomy?

When you rely on an experienced doctor like Dr. Cohen, you know what to expect and are guided through the potential after-effects and positive lifestyle change suggestions to ease your recovery. If you experience menopause, your CMP doctor helps you manage it with HRT. His extensive experience working with a wide range of women enables him to understand the various differences and effectively address them. Pain and discomfort are managed through his customized plans.

You may need to do proper fertility planning and consider options like in vitro fertilization or egg freezing if an oophorectomy is unavoidable for you. These options are confusing, so consulting a surgeon like Dr. Felix Cohen helps you make difficult choices while considering what’s medically necessary for you. Contact Dr. Cohen at Cohen Medical Practice right away for guidance.