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Salpingo-oophorectomy is a surgical procedure involving the removal of one or both of the fallopian tubes (salpingectomy) and one or both ovaries (oophorectomy). In a unilateral salpingo-oophorectomy procedure, only one fallopian tube and one ovary are removed. In the bilateral procedure, both fallopian tubes and both ovaries are removed. In women under the age of 40, an attempt is made whenever possible to preserve ovarian function by removing only one ovary or a part of one ovary.
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Source: Medical Disability Advisor
| A salpingo-oophorectomy may be performed to remove fluid-filled sacs (cysts), benign tumors (fibromas or teratomas), or abscesses. It is also done to treat chronic inflammation of the fallopian tubes (chronic salpingitis or tuberculous salpingitis), pelvic inflammatory disease, endometrial cells in the pelvic cavity (endometriosis), and breast and ovarian cancer. The procedure is used to remove the results of a pregnancy that develops in a fallopian tube rather than the uterus (ectopic pregnancy).
Salpingo-oophorectomy may also be performed with a hysterectomy as a part of the treatment for uterine cancer or for treatment of a cancerous tumor derived from placental tissue (choriocarcinoma). Salpingo-oophorectomy is used in breast cancer cases when the physician considers that a reduction in the amount of hormones produced by the ovaries (estrogens) may slow the growth of the cancer. Besides treating existing ovarian cancer, the procedure is sometimes used to remove healthy ovaries as a preventive (prophylactic) measure in reducing the risk of ovarian cancer in high-risk women. |
Source: Medical Disability Advisor
| The salpingo-oophorectomy procedure is performed in a hospital or outpatient clinic under local or general anesthesia. Laparoscopy is the most common method and begins with a tiny incision in the abdomen in or near the navel. The surgeon inserts a slender telescope-like instrument (laparoscope) through the incision. A second small incision is made just above the pubic hairline and a probe inserted to locate and remove the ovaries and fallopian tubes.
Another often-used method is called the minilaparotomy. It requires an incision about 2 inches long in the lower abdomen and does not employ a viewing instrument. The incision provides access for the removal of the ovaries and fallopian tubes.
A third, less common, more invasive method is called laparotomy and requires an extensive 2 to 5 inch incision in the lower abdomen.
Two other procedures called magnified visual inspection (culdoscopy) and surgical incision in the vagina (colpotomy), respectively, facilitate reaching the ovaries and fallopian tubes through the vagina rather than the abdomen. Neither of these procedures is often used.
Decisions regarding the most appropriate method to be used depend on the woman's age, weight, previous lower abdominal surgeries, heart and lung conditions, and other considerations. |
Source: Medical Disability Advisor
| The predicted outcome after salpingo-oophorectomy depends on the reason for the procedure (removal of cysts, benign tumors, or abscesses; or treatment of ovarian cancer, endometriosis, or pelvic inflammatory disease), the method used (laparoscopy, minilaparotomy, or laparotomy), and whether the procedure was unilateral or bilateral.
If the procedure is done to remove cysts, benign tumors, and abscesses located in or on the ovaries or fallopian tubes, removal of the ovaries and fallopian tubes (in most cases) produces a successful outcome. If the purpose of the procedure is to treat endometriosis, a condition in which the inner lining of the uterus (endometrium) grows in or on the fallopian tubes and ovaries as well as in the uterus, removal of the tubes and ovaries leads to a successful outcome. If, however, endometrial growth has occurred at other body sites, such as the intestines, bladder, and rectum, then treatment with salpingo-oophorectomy will not be completely successful.
If ovarian cancer is the reason for the procedure, the success of the procedure depends on the stage of the cancer. If the cancer has spread outside the ovaries and fallopian tubes, a salpingo-oophorectomy provides only partial treatment. It delays the spread of the cancer and alleviates symptoms but is not a cure. Similarly, if the procedure is being done to treat pelvic inflammatory disease and the inflammation has spread to sites other than the fallopian tubes and ovaries, the treatment will not be completely successful.
In general, most individuals recover fully, having experienced no problems from the anesthesia or the surgery with any of the three methods. Individuals treated with the laparoscopic method recover more quickly with fewer problems. Whether the procedure is unilateral or bilateral usually does not affect the outcome, because the effect of the procedure and the healing from the surgery occur at much the same rate for removal of one or both fallopian tubes and ovaries. However, hormonal complications for premenopausal women may arise if both ovaries are removed. |
Source: Medical Disability Advisor
| As with any procedure performed under general anesthesia, reaction to the anesthesia and breathing problems are possible complications. Some individuals experience complications with the surgery itself, such as bleeding, infection, or bands of scar tissue (adhesions). On rare occasions, the bowels or vessels may be injured during surgery and require additional surgical repair.
Longer-term complications occur when ovaries are removed prior to menopause. When unilateral salpingo-oophorectomy is used for premenopausal women, normal hormone production continues in the remaining ovary. However, when bilateral salpingo-oophorectomy is used for premenopausal women, normal hormone production is halted. A quarter of premenopausal women, having hysterectomies, also have bilateral salpingo-oophorectomies (Stenchever 805). Bilateral salpingo-oophorectomies cause acute menopause, a condition that often requires therapy. Since estrogen levels in premenopausal women are higher than those in postmenopausal women, premenopausal women require a much higher dose of estrogen or hormone replacement than women entering menopause naturally.
Another complication of the removal of both fallopian tubes and both ovaries occurs for premenopausal women who wish to become pregnant. After the procedure, the woman will be sterile. |
Source: Medical Disability Advisor
| Extended sick leave may be necessary, depending on whether the method was a laparoscopy, minilaparotomy, or laparotomy. The length of sick leave is contingent on the age of the woman, surgical complications, and resulting diagnoses and prognoses.
Most individuals treated with laparoscopies can return to work or resume previous activities with minor restrictions, such as refraining from strenuous exercise or heavy lifting for up to 2 weeks. Individuals treated with more invasive procedures (minilaparotomies and laparotomies) usually require a longer leave of absence from work and stricter restrictions.
Allowances may also have to be made for rest periods at work, shorter work hours, and/or fewer workdays per week. |
Source: Medical Disability Advisor
| Stenchever, Morton. "Postoperative Counseling and Management." Comprehensive Gynecology. 4th ed. St. Louis: Mosby, Inc., 2001. 805-806. MD Consult. Elsevier, Inc. 3 Nov. 2006 <http://home.mdconsult.com>. |
Source: Medical Disability Advisor
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