Introduction
An oophorectomy is a surgical procedure to remove one or both of a woman’s ovaries. The ovaries are small, almond-shaped organs located on either side of the uterus that produce eggs (ova) and secrete the primary female hormones, estrogen and progesterone. A unilateral oophorectomy removes one ovary, while a bilateral oophorectomy removes both. This surgery may be performed to treat ovarian cysts, ovarian cancer, endometriosis, or severe pelvic inflammatory disease. In some cases, a bilateral oophorectomy is performed prophylactically (preventatively) in women with a high genetic risk of developing ovarian or breast cancer, such as those with BRCA gene mutations.

Surgical Procedure
An oophorectomy can be performed using open surgery or minimally invasive techniques, often depending on the reason for the surgery and the size of the ovaries.
1. Laparoscopic Oophorectomy: This is the most common approach for non-cancerous conditions. The surgeon makes three or four tiny incisions in the abdomen. A laparoscope (a thin tube with a camera) and small surgical instruments are inserted. The surgeon carefully detaches the ovary from its blood supply and surrounding tissue and removes it through one of the small incisions, often using a special surgical bag.
2. Open Oophorectomy (Laparotomy): If cancer is suspected, or if the ovaries are severely enlarged or adhered to other organs due to endometriosis, a larger abdominal incision (horizontal or vertical) is required. This allows the surgeon to visually inspect the entire pelvic cavity and safely remove the ovaries and any surrounding affected tissue.

Surgical Risks
As with any surgery, risks include adverse reactions to anesthesia, bleeding, and infection. If both ovaries are removed in a woman who has not yet gone through menopause, the most significant consequence is immediate, surgically induced menopause.

General Complications
Common post-operative issues include:
– Pain and tenderness at the incision sites.
– Mild vaginal bleeding or discharge.
– Digestive sluggishness or constipation.
– If a bilateral oophorectomy is performed pre-menopause, symptoms of sudden estrogen withdrawal will occur, including severe hot flashes, night sweats, vaginal dryness, mood changes, and an increased long-term risk of osteoporosis and heart disease. Hormone Replacement Therapy (HRT) is often discussed to mitigate these effects.

Rare but Serious Complications
Severe complications are uncommon but can involve:
– Injury to the bladder, ureters, or bowel during the dissection of the ovaries.
– Internal bleeding requiring a return to the operating room.
– Severe pelvic infection.
– Hernia development at the incision site (more common with open surgery).

Pre-operative Preparation
– Medical Evaluation: Blood tests, a pelvic exam, and imaging (ultrasound, CT, or MRI) to evaluate the ovaries.
– Fasting: Patients must not eat or drink for 8 to 12 hours before the surgery.
– Medication Management: Blood-thinning medications should be stopped prior to surgery as directed by the physician.
– Bowel Preparation: A mild laxative or enema may be recommended the day before surgery to clear the bowels.

Post-operative Care
Laparoscopic patients often go home the same day or the next morning. Open surgery requires a hospital stay of 2 to 3 days. Pain is managed with prescribed medications. Early ambulation (walking) is encouraged to prevent blood clots in the legs and to help restart normal bowel function.

Wound Care
– Keep the incisions clean and dry. Showering is usually permitted, but avoid soaking in a bathtub or swimming pool until the doctor gives clearance.
– Laparoscopic incisions may be closed with surgical glue or dissolvable stitches. Open incisions may have staples that need to be removed at a follow-up visit.
– Monitor for signs of infection: increased redness, swelling, heat, or purulent drainage.

Diet
Start with clear liquids and gradually return to a normal diet. Eating high-fiber foods and staying well-hydrated is important to prevent constipation, which can cause painful straining.

Post-discharge Notes
Recovery from a laparoscopic procedure takes about 2 to 4 weeks, while an open oophorectomy requires 4 to 6 weeks.
– Avoid lifting anything heavier than 10 pounds and refrain from strenuous exercise for at least 4 to 6 weeks.
– Pelvic rest is required: no sexual intercourse, tampons, or douching for several weeks.
– Contact your doctor if you experience a fever, severe abdominal pain, heavy vaginal bleeding, or if you have concerns about menopausal symptoms.