Oophorectomy today occupies a prominent position in the field of medicine, with oophorectomy being one of the significant surgical procedures in gynecology. It is performed for various reasons, ranging from prevention to treatment. This procedure involves the removal of one or both ovaries and is considered a decisive therapeutic option in specific cases. It is also an effective method for controlling chronic pain or irregular bleeding caused by ovarian diseases. Surgical techniques have advanced significantly with the advent of laparoscopic and robotic surgeries. With continuous advancements in surgical methods, particularly minimally invasive laparoscopic surgery, oophorectomy has become safer and less invasive, contributing to the improved quality of life for women who require this type of treatment.
Oophorectomy in Turkey is now at the forefront of advanced surgical techniques, supported by a highly developed medical infrastructure and expert, experienced medical professionals. This procedure combines high precision with minimal surgical intervention, reducing complications and accelerating the recovery process.
What is the ovary?
The ovaries are part of the female reproductive system, which also includes the fallopian tubes, uterus, vagina, and vulva. The ovaries are located on either side of the uterus in the pelvis and are small, oval-shaped glands.
The ovary plays a key role in female puberty, serving as the primary center for the production of eggs and sex hormones such as estrogen and progesterone, which have a direct impact on regulating the menstrual cycle, developing secondary female characteristics, and maintaining the health of bones, the heart, and skin. The absence of both ovaries, whether due to surgical removal or functional failure, is a primary cause of infertility. As a woman ages and approaches menopause, the production of these hormones by the ovaries gradually decreases, leading to a complete cessation of the menstrual cycle. During this period, significant hormonal changes occur, affecting various bodily functions.
What are the reasons for Oophorectomy?
Doctors resort to Oophorectomy for many reasons, including the following:
- Tumors: one of the most common reasons for Oophorectomy, whether malignant or benign, poses a risk to the patient’s health.
- PCOS: If large ovarian cysts lead to complications for the patient, such as bleeding and pain, removing the affected ovary may be necessary
- Prevention: Women who carry the BRCA1 and BRCA2 genes may undergo Oophorectomy as a preventive measure against cancer.
- Severe endometriosis: In some extreme cases that do not respond to other treatments, surgical intervention may be necessary. The decision depends on the extent of disease spread, symptom severity, and fertility considerations.
- Ovarian torsion: If the ovary has sustained significant damage, Oophorectomy may be necessary to prevent complications such as infection or necrosis.
- Oophoritis: A rare but potentially serious condition. In severe cases where the ovary sustains permanent damage or large abscesses form that do not respond to treatment, Oophorectomy may be necessary to prevent complications such as the spread of infection or sepsis.
What are the methods of oophorectomy?
There are several methods for oophorectomy, each with its advantages and disadvantages. The choice of method is based on the patient’s health condition, the size of the ovary, the reason for surgery, the presence of other abdominal or pelvic diseases, and the hospital’s facilities and equipment. The methods include:
Laparoscopic Oophorectomy
Here, the surgeon removes the ovary by inserting a laparoscope through a small incision, using specialized surgical instruments introduced through several incisions to remove the ovary without the need for a complete abdominal opening.
One of the advantages of this method is the small incision size, which reduces the risk of postoperative complications, minimizes pain, and facilitates faster recovery with less noticeable scarring. However, performing this procedure requires a high level of surgical expertise. It may not be suitable for cases involving malignant or large tumors, or for severe adhesions within the abdomen that complicate visualization and treatment.
Oophorectomy through open surgery
It is a common method in which a large incision is made in the abdomen near the navel, allowing the surgeon to access the ovary and surrounding organs.
This method provides the surgeon with a comprehensive perspective, which makes it easier for him to deal with dangerous complications during the operation, such as the patient entering hemorrhagic or septic shock. However, this method requires a more extended recovery period, and the patient is more vulnerable than with laparoscopic surgery to infection, and the surgical scars are more prominent.
Transvaginal Oophorectomy
This method is usually used in conjunction with a hysterectomy, But the uterus does not have to be removed thanks to the vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) technique.
This technique is characterized by fewer incisions, which means less pain and more minor scars after surgery, Additionally, the recovery period is faster, and the risk of infection is lower, but this technique requires a very high level of expertise from the surgeon and depends on the patient’s anatomical condition and the suitability of the approach.
Preparing for an Oophorectomy
The patient must properly prepare before undergoing surgery to minimize risks and achieve the best possible surgical outcome. The following are steps that outline the most important things to do before the operation:
- Comprehensive medical examination: This includes blood tests such as measuring CA-125 protein levels and imaging studies to identify the location of the issue, assess ovarian health and surrounding factors, and evaluate any associated diseases.
- Taking medications: Before undergoing Oophorectomy, the doctor may recommend certain medications. For example, antibiotics may be prescribed to prevent infection, and the patient may be asked to discontinue certain medications, such as anticoagulants, to minimize the risk of bleeding during surgery.
- Exercise: Regular exercise helps prepare for the operation and aids in recovery; however, it is essential to consult your doctor before starting any exercise regimen.
- Mental health: Psychological factors play an important role in preparing for surgery. So it is advisable to have family and friends present to receive the necessary psychological support.
Quitting smoking and maintaining a healthy weight help reduce the risk of complications.
What are the complications of Oophorectomy?
Oophorectomy may cause complications; the appearance of complications depends on the type of surgery, the general health status of the patient, the method of removal used, and the most prominent potential complications include the following:
- Infertility: Removing both ovaries leads to infertility.
- Pain: Pain and swelling may occur, and they are usually managed with analgesic medications.
- Bleeding: Mild bleeding may occur; in rare cases, it may require surgical intervention.
- Deficiency of female hormones: Deficiency of female hormones may lead to symptoms such as early menopause, mood swings, and vaginal dryness.
- Cardiovascular diseases: Reduced estrogen levels may contribute to atherosclerosis, potentially through increased blood pressure and the accumulation of fat in the blood vessels.
- Blood clots: After surgery, patients may experience prolonged immobility, which increases the risk of deep vein thrombosis (DVT), particularly in the legs.
- Osteoporosis: Estrogen plays a crucial role in maintaining bone density, so its decline increases the risk of developing osteoporosis.
- Decreased libido: Oophorectomy may lead to reduced sexual desire in some women due to the decline in sex hormone levels.
Are there alternatives to Oophorectomy?
Yes, several alternatives can be considered, whether natural or surgical, that may serve as substitutes for Oophorectomy. These include:
- Drug therapy: Medical treatment can serve as an alternative to surgery, particularly when the primary target is symptom management. Drug therapy includes hormonal treatment or chemotherapy, which may eliminate the need for surgical intervention.
- Conservative surgery: Instead of complete ovarian removal, a partial Oophorectomy can be performed, where only the affected portion of the ovary is excised, preserving ovarian function and hormonal balance.
- High-Intensity Focused Ultrasound (HIFU): This non-invasive therapeutic technique can be used to reduce tumor size or alleviate symptoms by precisely targeting and ablating pathological tissue using focused ultrasound energy.
- Lifestyle optimization: Adopting a healthier lifestyle, including optimizing dietary habits, regular exercise, and incorporating appropriate nutritional supplements, can support ovarian health and alleviate symptoms without the need for Oophorectomy.
- Laparoscopic Ovarian Drilling: In some instances of polycystic ovary syndrome (PCOS), laparoscopic ovarian drilling can be performed to stimulate natural ovarian function without necessitating complete removal. This technique uses controlled cauterization to reduce excessive androgen production and improve ovulation.
In some cases, the doctor may follow up and opt for monitoring the patient rather than resorting to surgical intervention, such as for small ovarian cysts and certain benign tumors.
In conclusion, Oophorectomy may be necessary in some instances, such as the presence of tumors, ovarian cysts, torsion, severe inflammation, or for preventive purposes. While it can lead to hormonal changes and long-term health complications, the decision depends on a thorough assessment of the patient’s health and treatment goals. This decision should be made in consultation with a specialized medical team. Therefore, do not hesitate to seek advice from Bimaristan to ensure the best possible physical and psychological outcomes.
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