A salpingo-oophorectomy is the removal of the uterine tube, also known as the fallopian tube, and ovary on one or both sides. If it is done on one side, adverse effects are generally limited to standard risks of surgery. If it is performed on both sides, effects include those caused by hormone withdrawal. A health care professional and patient together can determine the best management plan for the side effects of a bilateral oophorectomy. Some options include non-hormonal drugs, vitamins and minerals to treat and prevent osteoporosis. Hormonal options, such as estrogen replacement, also can treat some of the side effects, but carry side effects of their own, such as increased rates of blood clots.
Standard Surgical Complications
Though generally low, there are risks from undergoing any surgery. Standard risks of surgery include risks of anesthesia as well, such as an allergic reaction to a medication. Some of the risks of surgery include bleeding, infection, blood clots to the lungs, heart problems and damage to the surrounding organs. These risks are minimal in healthy patients, according to "Sabiston Textbook of Surgery" by Dr. Courtney M. Townsend Jr.. If surgery is undertaken, a health care professional has weighed the risks and benefits of the procedure.
Cardiovascular Effects
If one ovary is removed, the other continues to make hormones such as estrogen for the body. If both ovaries are removed, then the body no longer produces estrogen. One effect of the removal of the ovaries is the increased risk of cardiovascular disease. Estrogen and other hormones have a protective effect on the blood vessels and heart. The removal of the ovaries, or onset of menopause increases the risk of diseases such as atherosclerosis, or hardening and narrowing of the arteries. This can increase the risks of problems such as heart attacks, according to "Harrison's Principles of Internal Medicine" by Anthony S. Fauci.
Mortality
A study published in the journal "The Lancet Oncology" in 2006 found that mortality was not increased in any group of patients who underwent removal of one ovary. In addition the study found that overall mortality was not increased in women who underwent removal of both ovaries. However, in women who underwent removal of both ovaries before the age of 45, there was an increased mortality rate. The results were inconclusive as to whether the increased mortality rate was due to the underlying disease process that lead to the removal of both ovaries, or caused by the removal of both ovaries.
Osteoporosis
The removal of both ovaries is also linked to increased risks of osteoporosis according to "Harrison's Principles of Internal Medicine." Osteoporosis is a disorder of bone breakdown and formation in which the bones become thin and brittle. This also increases the risk of fracture.
Sexuality
Decreased levels of estrogen and testosterone after bilateral oophorectomy has a number of side effects on sexuality. Women may experience decreased libido, problems with arousal and vaginal dryness.
References
- "Sabiston Textbook of Surgery"; Courtney M. Townsend Jr. et al.; 2007
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci et al.; 2008
- "The Lancet Oncology"; Survival patterns after oophorectomy in premenopausal women: a population-based cohort study; Rocca, Grossardt, de Andrade et al.; October 2006
