A bilateral salpingo-oophorectomy is a surgical procedure to remove both fallopian tubes (salpingectomy) and both ovaries (oophorectomy). It may be performed to treat or prevent various gynecological conditions, including ovarian cancer, endometriosis, and chronic pelvic pain.
Why Is a Bilateral Salpingo-Oophorectomy Performed?
- To treat ovarian or fallopian tube cancer.
- To reduce the risk of ovarian and breast cancer in women with a BRCA gene mutation.
- To manage chronic pelvic pain caused by endometriosis or pelvic inflammatory disease (PID).
- To treat large ovarian cysts or tumors.
- As part of a hysterectomy for other gynecological issues.
- To prevent future ovarian or fallopian tube disease in high-risk patients.
Procedure Overview
- Preparation:
- Avoid eating or drinking for at least 8 hours before the procedure.
- A complete blood count (CBC) and other lab tests may be performed before surgery.
- You may need to stop taking certain medications, including blood thinners, before surgery.
- During the Procedure:
- The procedure can be performed laparoscopically (minimally invasive) or through an open abdominal incision.
- Laparoscopic Salpingo-Oophorectomy:
- Small incisions are made in the abdomen.
- A camera and surgical instruments are inserted.
- The fallopian tubes and ovaries are carefully separated and removed.
- The incisions are closed with sutures or surgical glue.
- Open Salpingo-Oophorectomy:
- A larger incision is made in the lower abdomen.
- The fallopian tubes and ovaries are removed under direct visualization.
- The incision is closed with sutures.
- The procedure typically lasts 1 to 2 hours.
- Aftercare:
- You may stay in the hospital for 1 to 2 days after the procedure.
- Pain and discomfort are common for the first few days and can be managed with medication.
- Avoid heavy lifting and strenuous activity for at least 4 to 6 weeks.
- Most women can return to normal activities within 2 to 4 weeks after a laparoscopic procedure.
- Follow up with your doctor to monitor healing and discuss hormone replacement therapy (if needed).
Possible Risks and Complications
- Infection at the incision site.
- Bleeding during or after surgery.
- Damage to nearby organs such as the bladder or bowel.
- Formation of scar tissue (adhesions) in the pelvis.
- Early onset of menopause if both ovaries are removed.
- Hormonal imbalance leading to hot flashes, mood swings, and vaginal dryness.
Frequently Asked Questions
1. Will I go into menopause after a bilateral salpingo-oophorectomy?
Yes, removing both ovaries will cause immediate menopause unless you are already postmenopausal.
2. Can I still get pregnant after this procedure?
No, removing both ovaries and fallopian tubes means you will no longer produce eggs or have the ability to conceive naturally.
3. Will I need hormone replacement therapy (HRT)?
If the procedure causes early menopause, your doctor may recommend HRT to manage symptoms and protect bone health.
4. How long does recovery take?
Recovery from laparoscopic surgery takes about 2 to 4 weeks, while recovery from an open procedure may take 6 to 8 weeks.
5. Are there long-term health effects?
Yes, early menopause can increase the risk of osteoporosis and heart disease, which may require medical management.
6. Can this procedure reduce the risk of ovarian cancer?
Yes, removing the ovaries and fallopian tubes significantly reduces the risk of ovarian and fallopian tube cancer.
7. Can hormone therapy help with postmenopausal symptoms?
Yes, hormone replacement therapy can help manage symptoms like hot flashes, mood changes, and bone loss.