Bilateral Salpingo Oophorectomy

What is Bilateral Salpingo Oophorectomy

Bilateral salpingo oophorectomy is the surgical removal of both fallopian tubes and both ovaries. The ovaries are reproductive organs that produce eggs in women. The fallopian tubes allow eggs to move from the ovaries to the uterus.

You may need this procedure if you:

  • Have had your uterus removed. This procedure is usually done after the uterus is removed.
  • Have cancer of the fallopian tubes or ovaries.
  • Have a high risk of cancer of the fallopian tubes or ovaries.

There are three different techniques that can be used for this procedure:

  • Open. One large incision will be made in your abdomen.
  • Laparoscopic. A thin, lighted tube with a small camera on the end (laparoscope) will be used to help perform the procedure. The laparoscope will allow your surgeon to make several small incisions in the abdomen instead of one large incision.
  • Robot-assisted. A computer will be used to control surgical instruments that are attached to robotic arms. A laparoscope may also be used with this technique.

As a result of this procedure, you will become sterile(unable to become pregnant), and you will go into menopause(no longer able to have menstrual periods). You may develop symptoms of menopause such as hot flashes, night sweats, and mood changes. Your sex drive may also be affected.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding.
  • Allergic reactions to medicines.
  • Damage to other structures or organs.
  • Blood clots in the legs or lungs.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do not take these medicines before your procedure if your health care provider instructs you not to.
  • You may be given antibiotic medicine to help prevent infection.

General instructions

  • Do notsmoke for at least 2 weeks before your procedure or as told by your health care provider.
  • You may have an exam or testing.
  • You may have a blood or urine sample taken.
  • Ask your health care provider how your surgical site will be marked or identified.
  • Plan to have someone take you home from the hospital.
  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

  • To reduce your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
    • Hair may be removed from the surgical area.
  • An IV tube will be inserted into one of your veins.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to make you fall asleep (general anesthetic).
  • A thin tube (catheter) will be inserted through your urethra and into your bladder. The catheter drains urine during your procedure.
  • Depending on the type of surgery you are having, your surgeon will do one of the following:
    • Make one incision in your abdomen (open surgery).
    • Make two small incisions in your abdomen (laparoscopic surgery). The laparoscope will be passed through one incision, and surgical instruments will be passed through the other.
    • Make several small incisions in your abdomen (robot-assisted surgery). A laparoscope and other surgical instruments may be passed through the incisions.
  • Your fallopian tubes and ovaries will be cut away from the uterus and removed.
  • Your blood vessels will be clamped and tied to prevent too much bleeding.
  • The incision(s) in your abdomen will be closed with stitches (sutures) or staples.
  • A bandage (dressing) may be placed over your incision(s).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • You may continue to receive fluids and medicines through an IV tube.
  • You may continue to have a catheter draining your urine.
  • You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
  • You will be given pain medicine as needed.
  • Do notdrive for 24 hours if you received a sedative.

Summary

  • Bilateral salpingo-oophorectomy is a procedure to remove both fallopian tubes and both ovaries.
  • There are three different techniques that can be used for this procedure, including open, laparoscopic, and robotic. Talk with your health care provider about how your procedure will be done.
  • As a result of this procedure, you will become sterile and you will go into menopause.
  • Plan to have someone take you home from the hospital.

Bilateral Salpingo-Oophorectomy, Care After

What can I expect after the procedure?

After the procedure, it is common to have:

  • Abdominal pain.
  • Some occasional vaginal bleeding (spotting).
  • Tiredness.
  • Symptoms of menopause, such as hot flashes, night sweats, or mood swings.

Follow these instructions at home:

Incision care

  • Keep your incision area and your bandage (dressing) clean and dry.
  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), staples, skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.

Check your incision area every day for signs of infection. Check for:

  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • Do not drive for 24 hours if you received a medicine to help you relax (sedative) during your procedure.
  • Take frequent, short walks throughout the day. Rest when you get tired. Ask your health care provider what activities are safe for you.
  • Avoid activity that requires great effort. Also, avoid heavy lifting. Do notlift anything that is heavier than 10 lbs. (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe to do so.
  • Do not douche, use tampons, or have sex until your health care provider approves.

General instructions

  • To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
    • Drink enough fluid to keep your urine clear or pale yellow.
    • Take over-the-counter or prescription medicines.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
  • Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have pain when you urinate.
  • You have pus or a bad smelling discharge coming from your vagina.
  • You have redness, swelling, or pain around your incision.
  • You have fluid or blood coming from your incision.
  • Your incision feels warm to the touch.
  • You have pus or a bad smell coming from your incision.
  • You have a fever.
  • Your incision starts to break open.
  • You have pain in the abdomen, and it gets worse or does not get better when you take medicine.
  • You develop a rash.
  • You develop nausea and vomiting.
  • You feel lightheaded.

Get help right away if:

  • You develop pain in your chest or leg.
  • You become short of breath.
  • You faint.
  • You have increased bleeding from your vagina.

Summary

  • After the procedure, it is common to have pain, bleeding in the vagina, and symptoms of menopause.
  • Follow instructions from your health care provider about how to take care of your incision.
  • Follow instructions from your health care provider about activities and restrictions.
  • Check your incision every day for signs of infection and report any symptoms to your health care provider.
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