Oophorectomy, Reasons,Considerations and Procedure

That’s a big word that refers to a pair of small organs: the ovaries. Specifically, oophorectomy refers to the surgical removal of one or both ovaries. Why would a woman have her ovaries removed? Let’s examine some reasons why women undergo oophorectomy.

WHAT IS OOPHORECTOMY?

Pronounced ‘oh-uh-fer-EK-tuh-me,’ this word simply means ‘removal of the ovaries.’ The medical term for removal of both ovaries is ‘bilateral oophorectomy.’ Removal of the ovaries and Fallopian tubes is called ‘salpingo-oophorectomy.’

Oophorectomy surgery often is done along with hysterectomy, which is the removal of the uterus. Removal of the ovaries used to be quite common, but new research points to the benefit of leaving the ovaries intact whenever possible.

REASONS WOMEN GET OOPHORECTOMIES

Hysterectomy remains a common surgical procedure in the United States, despite questions about whether or not it is medically necessary in every case. According to some sources, at least 20 million American women have undergone a hysterectomy.

Many women use the term ‘hysterectomy’ or ‘complete hysterectomy’ to refer to removal of the uterus and ovaries, but this is incorrect usage. Hysterectomy specifically means taking out the uterus. Today, many women choose to leave their ovaries intact when they have a hysterectomy. Numerous studies suggest women who keep their ovaries have lower rates of heart disease, among other benefits.

Certain medical conditions require the removal of an ovary. These include:

  • Ovarian cancer. Removal of the affected ovary (at a minimum) usually is the first-line treatment for this type of cancer. Both ovaries, the uterus and other tissues may be removed if the cancer has spread within the abdominal cavity.
  • Benign ovarian cyst. Sometimes an ovary will become encapsulated in a non-cancerous, fluid-filled sac called a ‘cyst.’ An ovarian cyst can be very painful. However, it often clears up on its own. Surgery is not a primary treatment for ovarian cysts, but it may be necessary if the cyst is very large or if there’s any question about whether the ovary contains cancerous cells.
  • Ovarian torsion. Rarely an ovary and its Fallopian tube will rotate inside the abdominal cavity, twisting the artery that supplies blood to the ovary. When this happens, the blood supply to the ovary may be cut off. This situation is called ‘adnexal torsion’ and represents a medical emergency. Surgeons usually will try to save the ovary by un-twisting it, but in most cases the ovary is removed. Interestingly, ovarian torsion happens more often on the right side than on the left.
  • Ectopic pregnancy. Under normal circumstances, a fertilized egg from the ovary travels down the Fallopian tube into the uterus, where it attaches to the uterine wall. Sometimes, however, the egg attaches to structures outside the uterus — often to the ovary or Fallopian tube. When this happens, the growing embryo destroys adjacent structures. An ectopic pregnancy must be removed as soon as possible. Sometimes this means removing the adjacent ovary

Luckily, most women can maintain their fertility with only one functional ovary, so removing one should not affect your chances of getting pregnant.

HOW IS OOPHORECTOMY PERFORMED

Surgeons have a choice of options for removing an ovary. Among the more common are:

  • Abdominal. This procedure involves making a significant incision in the abdomen, removing one or both ovaries and then suturing the incision closed. An abdominal oophorectomy is used when a large mass must be removed or if the patient has a condition called ‘adhesions.’ This procedure leaves a more visible scar than other approaches.
  • Laparoscopic. In this procedure, the surgeon makes three or four small incisions in the abdomen and inserts a camera and thin instruments into the abdomen. This approach may be used when a small mass must be removed and no adhesions or other conditions exist that would make a laparascopic approach unfeasible. This procedure leaves a trio of very small scars.
  • Transvaginal. Meaning ‘through the vagina,’ this method of oophorectomy is used only in conjunction with a transvaginal hysterectomy. It leaves no scars.

OOPHORECTOMY CONSIDERATIONS

If you’re considering a hysterectomy, you need to know the current evidence supports leaving the ovaries intact. The only exceptions are women with a strong history of ovarian cancer in the family and a specific BRCA gene mutation. You should talk to your doctor about the risks and benefits of leaving your ovaries intact during hysterectomy