Ovariectomy: Treatment, Cost and Side Effects

Ovariectomy is the procedure wherein either one or both the ovaries are removed from the reproductive system of a woman. The ovaries are two almond shaped organs present on two sides of the uterus and its function is to produce and release eggs. Also known as oophorectomy, the procedure is done to treat other disorders like chronic pelvic pain, benign tumours, ectopic pregnancy, large ovarian cysts and pelvic inflammatory disease. The procedure is performed when the ovaries start releasing excess hormones to cause severe endometriosis and also breast cancer. Prophylactic ovariectomy is done to decrease the chance of ovarian cancer in women who have mutations in their BRCA1 and BRCA2 genes. The procedure involves several steps to remove the ovaries depending upon the reason of the surgery. Sometimes, along with the ovaries the fallopian tubes may also be removed to lower the risk of ovarian cancer. This particular procedure of removing both ovaries and fallopian tubes is known as salpingo-oophorectomy. Sometimes only one ovary is removed and the procedure is called unilateral oophorectomy. Similarly, if both the ovaries are removed, it is known as bilateral oophorectomy. Before undergoing the surgery, the patient will be required to get physical examination done, some urine and blood tests done and a few imaging tests like ultrasound and CT scan done.

Ovariectomy can be performed using different techniques. Before starting with the procedures the patient is first anesthesized using general anesthesia. The surgical approach used for ovariectomy can vary according to the situation of the patient. It takes about 2-5 hours to complete the surgical procedure. The different types of techniques used for ovariectomy are open abdominal surgery, laparoscopic procedure and robotic surgery. Open abdominal surgery is a conventional procedure where the surgeon makes an incision in the abdomen and then removes the ovaries. Most often, during an ovariectomy, the fallopian tubes are also removed to cancel any risk of future ovarian cancer. After the surgery, the incision is closed either by gluing, stapling or by stitching. The other procedure called laparoscopic surgery can be done under general as well as local anesthesia. Laparoscopic surgery does not require a large incision to be made in the abdomen to remove the ovaries. In this procedure a tube attached to a camera and a light source is inserted into the lower abdomen to reach the ovaries through several small holes in the abdomen. After the surgeon can access the ovaries, they are carefully removed and then the small holes are closed. In robotic surgery also, the ovaries are removed by making small holes in the abdomen. Here, instead of using a laparoscope a robotic arm is used which is fixed to a camera. A robotic arm provides much better visualisation of the visceral organs. The movements of the robotic arm inside the abdomen are also very precise and the procedure is quite efficient in locating the organs for successful removal.

A person affected either with ovarian cancer or cysts, benign tumours, abscesses or pelvic infection, endometriosis, ectopic pregnancy or ovarian torsion will be eligible for treatment. If the woman also has a risk of breast cancer and is a carrier o BRCA gene mutations, she will be eligible for treatment.

Women in their premenopausal phase and would want to conceive in this period, would be required to discuss the issues with the doctor as she will not be eligible for the treatment then.

Side effects of ovariectomy can be infection, allergic to anesthesia, bleeding, blood clots and damage to other nearby organs. The symptoms that the patient experiences after the surgery due to the side effects are vaginal dryness, hot flashes, anxiety and depression and changes in sex drive. Serious complications can be faced if the patient is an obese or have diabetes or is a smoker.

Post treatment guidelines for open abdominal surgery are to stay in the hospital for about 2 to 3 days for careful observation by the doctor. It is strictly recommended not to use creams or lotions on the incised areas. After regaining consciousness from anesthesia, the patient is made to walk slowly to prevent blood clots. The patient will also be instructed not to lift heavy weightsafter the surgery.

After a laparoscopic surgery it may take only two weeks to recover and return to normal work. If open abdominal surgery is done, it may take longer like 6 or more weeks to recover completely.

The cost of ovariectomy in India may range from Rs. 50,000 to Rs. 5.5 lakh.

Yes, the results are permanent.

The alternative treatment options for preventing ovarian cancer, breast cancer, ectopic pregnancy can be medication and radiation therapy.