Oophorectomy (Ovary Removal Surgery)

What is an oophorectomy?

An oophorectomy is a surgical procedure that removes one or both of your ovaries.

What are ovaries?

Ovaries are small almond-shaped organs on each side of the uterus in the pelvis responsible for producing the egg cells, also called ova or oocytes.

Upon reaching puberty, a woman's ovaries release an egg through a monthly process called ovulation. The ova are transferred to the fallopian tube where it is possible to be fertilised by a sperm. Thus, the ovaries are the primary reproductive organs of females.

Aside from producing ova, the ovaries also secrete oestrogen and progesterone – the hormones essential in fertility and reproductive development.

Types of oophorectomy

There are various reasons to remove one or both ovaries. Depending on why you will be needing the procedure, your doctor may recommend one of the following types of oophorectomy:

• Bilateral oophorectomy – removal of both ovaries
• Unilateral oophorectomy – removal of one ovary
• Salpingo-oophorectomy – ovary removal surgery may be done with a salpingectomy because the ovaries and fallopian tubes share a common blood supply.
• Oophorectomy with hysterectomy – oophorectomy is often performed as part of a larger surgery, such as a hysterectomy (surgical removal of the womb).

Why do you need an oophorectomy?

Your gynaecologist might recommend an oophorectomy to treat:

• Tubo-ovarian abscess – a pus-filled pocket involving a fallopian tube and ovary
• Ovarian cancer
• Endometriosis – when the inner lining of the uterus grows outside it
• Non-cancerous (benign) ovarian tumours or cysts
• Ovarian torsion – twisting of an ovary
• Chronic pelvic pain
• Pelvic inflammatory (swelling) disease

An oophorectomy may also be used to reduce the risk of ovarian cancer or breast cancer for high-risk women.

What are the risks of oophorectomies?

While an oophorectomy is a generally safe procedure, there are still risks involved in an ovary removal surgery. Oophorectomy risks and side effects include the following:

• Bleeding
• Infection
• Damage to nearby organs
• Negative reaction to anaesthesia
• Blood clots
• Rupture of tumour
• Infertility (if both ovaries are removed)
• Heart disease
• Long-term increased risk of Parkinsonism, dementia, and depressive and anxiety symptoms

How do you prepare for an oophorectomy?

To prepare for your surgery:

• Follow dietary guidelines that your doctor will give you. You may be asked to skip meals and limit liquid intake for a certain number of hours prior to the surgery.
• Talk to your doctor about your ongoing medications and medical history. You may be instructed to stop or modify certain medications prior surgery.
• Undergo a series of tests including blood tests and ultrasound.
• Raise your fertility concerns. If you are considering getting pregnant after surgery, your doctor may discuss with you the options to preserve your ability to become pregnant, depending on your particular situation. Ask your doctor to refer you to a fertility specialist who can review your options with you.

What can you expect in an oophorectomy?

You will be under general anaesthesia during an oophorectomy surgery. This means you will be completely unconscious during the procedure.

Estimated duration

The treatment takes around 45 minutes.

During the procedure

Depending on your condition, your doctor can choose from 3 different types of surgery:

• Laparotomy – one long incision is made in your lower abdomen to remove the ovaries
• Minimally invasive laparoscopic surgery – very small incisions are made in your abdomen. A tube with camera is inserted in one of the incisions, while other surgical tools are inserted through the other incisions. The camera will transmit a video to a monitor, which will serve as a guide for the surgeon. The ovaries are them removed and placed in a pouch, which will be pulled out through one of the incisions.
• Robotic surgery – can be done with the help of a surgical robot. In this procedure, the surgeon watches a 3D monitor and uses hand controls that allow movement of the surgical tools.

After the procedure

You will have to stay in a recovery room to wait for the anaesthesia to wear off. Afterwards, you will be moved to a hospital room where your condition will be monitored for a certain period, depending on your type of surgery and recovery. There are some cases where patients are able to go home on the same day of surgery.

Typically, patients are able to return to full activity in 2 – 4 weeks after surgery. You have to follow your doctor's guidelines on certain activities like exercise, driving, and sexual activities.