What is an oophorectomy?

An oophorectomy is an operation to remove one of or both your ovaries. The fallopian tube connected to your ovary is usually removed at the same time.

What are the benefits of surgery?

Needing to remove an ovarian cyst is the most common reason for having an oophorectomy. A cyst can cause symptoms such as pain, bloating, pressure on your bowel or bladder, and sometimes tiredness. An oophorectomy should improve your symptoms.

Some women have a family history of ovarian cancer so removing their ovaries will remove the risk of developing ovarian cancer.

An oopherectomy may also be performed to treat problems such as a twisted ovary and endometriosis, where the lining of your uterus (womb) grows outside your womb.

Are there any alternatives to surgery?

Pain is usually controlled with painkillers or by using hormone treatment such as the oral contraceptive pill.

If you have not yet gone through menopause, small cysts can usually be safely left alone.

What will happen if I decide not to have the operation?

Your doctor will monitor your condition and try to control your symptoms.

You may feel that you would prefer to put up with your symptoms rather than have an operation.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes about 30 minutes.

Your gynaecologist will make a small cut, usually on or near your belly button, so they can insert an instrument in your abdominal cavity to inflate it with gas (carbon dioxide). They will make 2 to 3 small cuts on your abdomen so they can insert tubes (ports) into your abdomen. Your gynaecologist will insert surgical instruments through the ports along with a telescope so they can see inside your abdomen and perform the operation.

For each ovary that needs to be removed, your gynaecologist will separate your ovary, and usually the connected fallopian tube, from the blood supply and surrounding tissue. They will remove your ovary through one of the small cuts.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Feeling or being sick.
• Bleeding during or after the operation.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Developing a hernia in the scar.
• Venous thromboembolism (VTE) — this is a blood clot in your leg (deep-vein thrombosis - DVT) or one that has moved to your lung (pulmonary embolus).
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

Keyhole surgery complications

• Surgical emphysema (a crackling sensation in your skin caused by trapped carbon dioxide), which settles quickly and is not serious.
• Damage to structures such as your bowel, bladder or blood vessels when inserting instruments into your abdomen. If an injury does happen, you may need open surgery. About 1 in 3 of these injuries is not obvious until after the operation.
• Making a hole in your womb or cervix with possible damage to a nearby structure during placement of the manipulator. You may need another operation.
• Developing a hernia near one of the cuts used to insert the ports.
• Gas embolism. This is when gas (carbon dioxide) gets into the bloodstream and blocks a blood vessel.
• Conversion to open surgery. Open surgery can increase your risk of some complications such as VTE, bleeding and infection.

Oophorectomy complications

• Ovarian remnant syndrome, where you continue to get symptoms similar to a period such as pain, bloatedness, headaches and premenstrual tension, if your gynaecologist was not able to remove all your ovarian tissue.
• Damage to a ureter (tube that carries urine from a kidney to your bladder). Your gynaecologist will usually notice any damage and repair it during the operation. However, damage may not be obvious until after the operation and you may need another operation.

Consequences of this procedure

• Pain.
• Unsightly scarring of your skin.
• Infertility, if you have both ovaries removed and you have not already gone through the menopause.

How soon will I recover?

You should be able to go home the same day.

Rest for 1 to 2 days and take painkillers if you need them.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most women make a good recovery and return to normal activities.

Summary

An oophorectomy is an operation to remove one of or both your ovaries. An ovarian cyst is the most common reason for having an oophorectomy. It is also performed to treat problems such as a twisted ovary and to remove the risk of developing ovarian cancer.

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