A salpingo oophorectomy is a surgical procedure that removes one or both ovaries along with the attached fallopian tubes. Your provider may recommend this surgery to treat conditions such as ovarian cancer, endometriosis, ovarian cysts, or pelvic infections. In some cases, it is performed as a preventive measure for women who carry a high genetic risk of ovarian or breast cancer.

The surgery can be done on one side of the body (unilateral) or both sides (bilateral). It may also be performed at the same time as a hysterectomy. Your provider will walk you through which approach makes the most sense based on your health history, diagnosis, and goals for the future.

Why Is a Salpingo-Oophorectomy Performed?

Your provider may recommend a salpingo oophorectomy for several reasons. The surgery can be performed to treat an existing problem or to lower your future cancer risk.

Common reasons include:

• Ovarian cancer or possible ovarian tumor.
• Endometriosis that has not improved with other treatments.
• Ovarian cysts or benign tumors causing pain or pressure.
• Pelvic inflammatory disease or tubo-ovarian abscess.
• Ovarian torsion, which is a twisting of the ovary that cuts off blood supply.
• Risk reduction for women who carry BRCA1 or BRCA2 gene mutations or Lynch Syndrome.

Women with inherited genetic mutations like BRCA1 or BRCA2 face a significantly higher lifetime risk of developing ovarian and breast cancer. For these patients, a risk reducing salpingo-oophorectomy can lower ovarian cancer risk substantially. Your Baptist Health provider or a genetic counselor can help you understand whether this option is right for you.

Types of Salpingo-Oophorectomy

There are two main types of this procedure:

• Unilateral salpingo-oophorectomy. This type removes one ovary and one fallopian tube. Your provider might choose this option when the disease is limited to one side, or when preserving fertility is a priority. Because one ovary remains, the body can still produce hormones and eggs.
• Bilateral salpingo-oophorectomy. This type removes both ovaries and both fallopian tubes. After a bilateral procedure, your body will no longer produce its own estrogen or progesterone, and natural pregnancy is no longer possible. For premenopausal women, this results in surgical menopause.

How Is the Procedure Performed?

A salpingo oophorectomy is typically performed under general anesthesia, meaning you will be asleep throughout the surgery. Your surgical team will choose one of three approaches depending on the reason for your surgery, your medical history and the size of any masses.

Laparoscopic Salpingo Oophorectomy

This is a minimally invasive approach. The surgeon makes a few small incisions in the abdomen, usually near the navel. A laparoscope, which is a thin tube fitted with a camera and light, is inserted through one of the incisions. This allows the surgeon to see the pelvic organs on a video monitor. Carbon dioxide gas is pumped into the abdomen to create space between the organs and the abdominal wall. Surgical instruments are inserted through the other incisions to detach and remove the ovary and fallopian tube. A laparoscopic salpingo oophorectomy generally involves less blood loss, a shorter hospital stay and a quicker recovery compared to open surgery.

Robotic Salpingo-Oophorectomy

A robotic salpingo-oophorectomy follows a similar process to the laparoscopic approach. The main difference is that the surgeon controls the instruments through a robotic arm rather than by hand. This can provide enhanced precision and a greater range of motion during the operation. Recovery times for robotic surgery are generally comparable to laparoscopic procedures.

Open Surgery (Laparotomy)

In some situations, your surgeon may need to perform an open procedure. This involves a larger incision in the abdomen, either vertical or horizontal. Open surgery may be preferred when there is a large mass, a strong suspicion of cancer or significant scar tissue from previous surgeries. This approach requires a longer hospital stay and a more extended recovery period.

How to Prepare for Surgery

Your provider will give you specific instructions before the procedure. In general, you can expect to:

• Stop eating and drinking after midnight the night before your surgery.
• Review all current medications, vitamins and supplements with your surgeon.
• Arrange for someone to drive you home after the procedure.
• Ask your provider about stopping blood thinners or other specific medications.
• Prepare meals and set up your home so you can rest comfortably during recovery.

If you are premenopausal and having a bilateral procedure, talk to your provider about the hormonal changes you will likely experience afterward. You may also want to discuss fertility preservation options, such as egg freezing, before surgery.

Recovery After a Salpingo-Oophorectomy

Recovery time depends on the type of procedure you have. Many patients who undergo a laparoscopic or robotic salpingo-oophorectomy are able to go home the same day or after an overnight stay. Open surgery usually requires a hospital stay of two to three days.

In the first few days after surgery, it is normal for your abdomen to feel sore and possibly bruised. You may also experience shoulder or back discomfort from the gas used during a laparoscopic or robotic procedure. Mild nausea from the anesthesia is common, and some vaginal spotting or discharge may occur.

During the first week, you will likely feel more tired than usual. Plan to take it easy and gradually increase your activity with short walks. Avoid lifting heavy objects or doing strenuous exercise until your provider clears you.

Full recovery from a laparoscopic or robotic procedure typically takes about two to four weeks. For open surgery, expect a longer timeline of six to eight weeks before returning to your normal routine. Your provider will schedule a follow up appointment to check on your healing and discuss any next steps.

Incision Care

Your incisions will be closed with stitches, adhesive strips, or skin glue. If you have bandages, these can typically be removed 24 hours after surgery. Adhesive strips and dissolvable stitches will fall off on their own within about a week. You may shower but avoid rubbing the incision sites directly. Do not soak in a bathtub, hot tub or pool until your provider says it is safe to do so.

Risks and Possible Complications

A salpingo oophorectomy is a common and generally safe procedure, but as with any surgery, there are risks. Your surgical team will take careful steps to minimize these risks and will discuss them with you in advance.

Potential complications include:

• Bleeding or blood clots in the legs or lungs.
• Infection at the incision site.
• Injury to nearby organs such as the bladder or bowel.
• Adverse reaction to anesthesia.
• Hernia at an incision site.

Contact your Baptist Health provider or go to the emergency room if you develop a fever above 101 degrees, severe pain that does not improve with medication, heavy bleeding, redness or drainage at your incision, swelling or pain in your legs, or difficulty breathing.

Long Term Effects and Hormonal Changes

If you have a unilateral procedure and your remaining ovary is healthy, your body will continue to produce hormones and you will still have menstrual cycles. Most of the time, you'll still be able to have children.

Having both ovaries and fallopian tubes removed often triggers menopause right away if you have not gone through it yet. This happens because your ovaries make most of your body's estrogen and progesterone. Without these hormones, you may experience:

• Hot flashes and night sweats.
• Vaginal dryness.
• Mood changes.
• Sleep disruption.
• Increased risk of osteoporosis over time.
• Changes in heart disease risk.

Your provider may recommend hormone replacement therapy to manage these symptoms, depending on your age, overall health and the reason the surgery was performed. Long term follow up is important to monitor bone density, cardiovascular health, and overall wellbeing after bilateral removal.

Fertility Considerations

If both ovaries and fallopian tubes are removed, you will not be able to conceive naturally. If your uterus remains, pregnancy may still be possible through in vitro fertilization using donor eggs or previously frozen eggs. Talk to your Baptist Health provider or a fertility specialist before surgery if you would like to explore options for preserving your fertility.

When to Call Your Provider

After surgery, reach out to your Baptist Health care team if you notice any of the following:

• Fever or chills.
• Pain that worsens or does not improve with prescribed medication.
• Redness, swelling, or pus at your incision site.
• Heavy vaginal bleedingaa.
• Nausea and vomiting that will not stop.
• Difficulty urinating or having a bowel movement.
• Swelling or pain in your calves or legs.
• Chest pain or trouble breathing.