A salpingo-oophorectomy is a surgical procedure to remove the ovaries and fallopian tubes. Doctors may recommend it for treating cancer, endometriosis, or an ectopic pregnancy.
The procedure can be either unilateral, which involves removing one ovary and fallopian tube, or bilateral, which means the surgeon will remove both ovaries and fallopian tubes.
In this article, we look at the reasons for a salpingo-oophorectomy and how to prepare for the surgery and ensure a smooth recovery.
A salpingo-oophorectomy is a surgical procedure that removes a person’s ovaries and fallopian tubes.
A person can have a bilateral salpingo-oophorectomy, where a surgeon removes both ovaries and fallopian tubes, or a unilateral salpingo-oophorectomy, which removes one ovary and fallopian tube.
Surgeons can perform a salpingo-oophorectomy independently or as part of a total hysterectomy where they also remove the uterus.
Typically, a gynecologic oncologist or gynecologic surgical specialist will perform the surgery. There are different ways in which a surgeon can perform a salpingo-oophorectomy.
A surgeon makes a small incision in the abdomen and inserts a laparoscope, which contains a small camera and light, into the pelvis.
These instruments help the surgeon locate the ovaries and fallopian tubes, which they remove through a second incision at the top of the vagina. The surgeon will then close the two incisions.
This procedure is less invasive and requires a shorter recovery time than open surgical procedures.
An open surgical procedure requires a larger incision in the abdomen or pelvis. This opening allows the surgeon to see the organs and remove them by hand through the incision.
Open procedures carry a greater risk for complications, such as infection, and have a longer recovery time.
A robotic procedure is similar to a laparoscopic procedure, except it uses a robotic arm to help the surgeon locate and remove the ovaries and tubes.
Regardless of which procedure is performed, removing the ovaries will cause a person to go into menopause.
If a person is below menopausal age at surgery, they will
Doctors may recommend a salpingo-oophorectomy to prevent or treat several conditions, including:
- Ovarian cancer: Sometimes, the doctor will recommend removing the entire ovary and fallopian tube, not just the tumor or growth.
- Ovarian mass: Benign (noncancerous) tumors, cysts, or abscesses may require the removal of the entire ovary or fallopian tube, especially if the mass is putting pressure on nearby structures or is causing pain or pressure.
- Endometriosis: Endometriosis occurs when pieces of endometriosis-like tissue grow outside of the uterus, including on the ovary or fallopian tubes. This condition can cause severe pain and discomfort and sometimes requires the removal of the uterus, ovaries, or fallopian tubes.
- Ectopic pregnancy: An ectopic pregnancy happens when a fertilized embryo implants into a location outside of the uterus. This requires immediate removal of the implanted embryo. If it implants in the fallopian tube, the entire tube may require removal.
- Ovarian torsion: In rare cases, the ligament connecting the ovary to the pelvic wall can twist or forms a knot, cutting off blood and nerve supply. Ovarian torsion requires emergency surgery to restore blood flow and prevent the ovary from dying.
People who have a high risk for ovarian cancer may elect to have a salpingo-oophorectomy. For example, those that carry the BRCA1 and BRCA2 genes may wish to have the procedure as a preventive measure.
Having a salpingo-oophorectomy can be overwhelming, and it can help to have an idea of what to expect.
Questions to ask
Before having the surgery, people may like to make a list of questions for the doctor. A few questions to think about include:
- How will the surgery be performed — open, laparoscopic, or robotic — and why?
- What about family planning issues? Am I done having children, or should I consider fertility preservation treatment?
- Am I a candidate for hormone replacement therapy? Why or why not? If not, how can I get ready for surgical menopause?
- Should I stop taking my medication or nutritional supplements?
- How long will the surgery take?
- Will I need to spend the night in the hospital?
- What is the expected recovery time?
- What restrictions will be in place after surgery?
The doctor should review and answer all of the questions before surgery and discuss the preparations a person may need to make before surgery.
Some people may need preoperative testing, especially if they have other health problems.
Though the doctor will give more specific information, someone having surgery may be required to:
- avoid eating food for a minimum of 6 hours before the procedure
- bring someone to drive them home afterward
- wear comfortable and loose-fitting clothing
It can also be helpful to prepare a hospital bag with a comfortable robe and socks, lip balm, toiletries, and a book or magazine.
A range of factors can affect recovery, including the type of procedure, a person’s general health, and whether they start hormone replacement therapy after surgery.
Typically, the recovery from a laparoscopic or robotic procedure is easier and quicker than open surgery.
A 2020 study found that most people could return to an overall sense of normality around 6 and a half weeks (46.3 days) after a surgery. However, some people may return to a sense of normality sooner or feel as though they have reached this stage.
There are a variety of things a person can do to make their recovery more comfortable, including:
- wearing loose and comfortable clothing following surgery
- preparing meals in advance or asking a loved one to help with daily meals
- avoiding any foods that cause gas
- setting up a comfortable recovery area in the home
- stocking up on anti-gas medications and painkillers
- asking someone to do any necessary physical tasks
The doctor should be able to provide additional information about what to expect.
Preventive bilateral salpingo-oophorectomy
Premenopausal people who have surgery to remove both of their ovaries and fallopian tubes will require menopausal hormone therapy following the procedure.
However, a 2020 study found that many people who have a salpingo-oophorectomy do not feel appropriately informed about postsurgery outcomes. Consulting with a primary care professional before and after the procedure may help a person develop an adequate recovery plan.
A salpingo-oophorectomy is a surgical procedure that removes one or both of a person’s ovaries and fallopian tubes.
Doctors may recommend a salpingo-oophorectomy to treat or prevent ovarian cancer, endometriosis, or ectopic pregnancy. The outlook for the procedure is typically positive.