Women have two ovaries in the pelvis, one on the left and one on the right. Ovaries are connected to the pelvis, the Fallopian tubes and the uterus by ligaments and blood vessels.
The ovaries are are highly active organs that produce and store the eggs needed for pregnancy, as well managing hormone regulation during puberty, the menstrual cycle and menopause.
In younger women, the ovaries are essential for falling pregnant naturally (i.e. without assisted reproduction). Removal of both ovaries during reproductive years results in premature menopause and the inability to fall pregnant naturally (because there is no ovulation). Therefore, amongst women of reproductive age, surgery involving the ovaries or female reproductive organs for non-cancerous reasons typically aims to preserve one or ideally both ovaries.
Read more about ovaries
What is an Oophorectomy?
Oophorectomy (oo-for-rec-to-me) is a surgical procedure to remove one (unilateral) or both (bilateral) ovaries.
To perform an oophorectomy, a general anaesthetic is required. Through 5-10mm cuts on the abdomen, medical gas is circulated into the abdomen and pelvis. Key-hole ‘ports’ are inserted into the abdomen which act like a passageway for the thin surgical camera and instruments to enter into the abdomen so the procedure can be performed. The blood vessels and ligaments around the ovary are secured and divided using a surgical electrical instrument to precisely seal and cut. Once completed, the ovary is placed in an extraction bag and retrieved through one of the abdominal skin incisions. The tissue removed is then sent to the laboratory for microscopic assessment.
An oophorectomy is typically performed using a minimally invasive surgery (‘key-hole’ surgery). In less frequent situations, a larger skin incision (called a laparotomy) is needed to complete the procedure.
Why is an oophorectomy performed?
An oophorectomy may be necessary in the following situations:
- Ovarian cancer
- Ovarian cysts or tumours
- Ovarian endometriosis (endometrioma)
- Infection – [when the ovary is involved in a pelvic abscess involving the uterus and Fallopian tube]
- Ovarian torsion — [The ovary can twist on itself, blocking the blood supply to the ovary. During the operation to untwist the ovary, it may be observed that the ovary will not return to normal function and needs to be removed.]
- Ovarian cancer risk reduction – [women with an increased genetic risk of ovarian or breast cancer might choose to have their ovaries removed at the completion of their families. Additionally, women who are undergoing other pelvic surgery (such as hysterectomy) may elect to have their ovaries removed to reduce their ongoing risk of ovarian cancer or other problems.]
- Retained ovary syndrome
Women might have different perspectives on removal or conservation of their ovaries. The decision to have an oophorectomy is personal, and is influenced by the reason for oophorectomy, the woman’s feelings about her ovaries and her age. Removal of ovaries under the age of 50-65 years might be associated with an overall reduction in life expectancy [ref]. This risk might be minimised by using hormone replacement []. This is because even after menopause, the ovaries continue to provide valuable hormones for the body to keep the brain, heart and bones healthy. [ref]
Our Before & Afters
FAQ
HOW LONG DOES AN OOPHORECTOMY TAKE?
Approximately 30 to 60 minutes to remove both ovaries.
The time taken to complete the procedure is influenced by the reason for oophorectomy, presence of adhesions and scar tissue, your individual anatomy, previous surgery and co-existing conditions like endometriosis.
Sometimes oophorectomy is done as part of another procedure like total hysterectomy and so the total operating time will be longer.
CAN I HAVE ONE OVARY REMOVED AND THE LEAVE THE OTHER ONE BEHIND?
Yes. This is called a unilateral oophorectomy (one ovary removed). This approach is typically adopted for women of reproductive age or who have not yet reached menopause who require the removal of a problematic ovary. With the removal of one ovary, the ovary on the other side of the pelvis remains and continues to function as normal.
Well after menopause and depending on other health factors, there may be no clear advantage in removing one problematic ovary and leaving one in the pelvis. In these situations, both ovaries can be removed.
WILL I GO INTO MENOPAUSE IF I HAVE MY OVARIES REMOVED?
Yes if you have both ovaries removed and you have not yet been through menopause, you will go into menopause. The ovaries are responsible for the production and regulation of the hormones involved in the menstrual cycle. When the ovaries are removed surgically with oophorectomy, the hormonal function of the ovaries is also ended. Each woman’s experience of menopause is individual. Some women have bothersome menopause symptoms, and some women have little or no bother.
CAN I USE ‘HRT’ OR MENOPAUSE HORMONE THERAPY IF I HAVE HAD AN OOPHORECTOMY?
Yes you can. If you have a bilateral oophorectomy (both ovaries removed) before you have gone through menopause, I typically recommend hormone replacement until the average age of menopause. If you have symptoms of menopause after a bilateral oophorectomy, these symptoms can also be managed with similar hormone replacement. Appropriate amounts of weight bearing exercise, and vitamin D and calcium intake are important non-hormonal therapies I recommend all women adopt for overall wellbeing.
WHAT ARE THE BENEFITS OF AN OOPHORECTOMY?
ASDF
WHAT ARE THE RISKS OF AN OOPHORECTOMY?
Reduction or complete loss of ovarian function (associated impact on ability to fall pregnant or menopause symptoms)
Reduction in total life expectancy if both ovaries removed under the age of 50 years (and maybe up to under 60 years)
Injury to organs and structures adjacent to the operative site (ureter, bowel, blood vessels)
Further surgery or medical treatment might be recommended if cancerous cells identified within the ovary
Read the Patient Information pages for more information on general anaesthetic and surgical risks.
WHAT ARE MY OPTIONS INSTEAD OF AN OOPHORECTOMY?
Options for care are determined by patient wishes and medical recommendations. Some women will decide to do nothing and ignore
HOW LONG IS RECOVERY AFTER AN OOPHORECTOMY?
Recovery from an oophorectomy is typically very short and well tolerated. This is because most commonly a minimally invasive (‘key-hole’) approach is used. This means the skin incisions are small, and there are minimal internal stitches or organs at risk after surgery.
Your key-hole skin incisions on your abdomen will be tender for about one week and can be managed with paracetamol and ibuprofen. You might experience bothersome shoulder tip pain that will ease in the days after surgery. You will be able to eat and drink as usual. Your bowels might be slower than usual and can be eased with stool softeners (like Movicol® or Coloxyl®). You are unlikely to notice any difference in bladder function, but any changes are typically temporary and mild.
Hospital stay: Your hospital stay might be only for the day of surgery, or you might need overnight admission for observation and recovery. If you have a laparotomy (larger skin incision), you will likely recover in hospital for at least 1 to 2 nights in hospital.
Returning to work: This depends on the type of work you are returning to. Women can return to office-based work usually within 1 -2 weeks after minimally invasive laparoscopic surgery and after 2-4 weeks following a laparotomy. More physically demanding work may require longer recovery. Consider if there are alternative, less-physically demanding roles you can do to ease your return to work.
Driving and travel: Typically, you can drive about 2 weeks after your minimally invasive surgery. Always check with your vehicle insurance provider and comply with any instructions they provide you. You typically need to wait at least 2 days before flying. Check with your airline so you can safely time your surgery and travel.
Intimacy, exercise and other activities: You should defer penetrative intercourse for 2 weeks and until any abnormal vaginal bleeding has settled. You can resume your usual physical activity and exercises 2-3 weeks after your surgery.
Your recovery is individual. Each day following surgery you can expect to have made some improvement in how you feel. Dr Dunn will happily discuss your specific recovery circumstances.
Read more in the Patient Information pages
