Oophorectomy and ovarian cystectomy
- Fidel A Valea, MD
Fidel A Valea, MD
- Associate Professor
- Division of Gynecologic Oncology
- Duke University Medical Center
- William J Mann, Jr, MD
William J Mann, Jr, MD
- Section Editor — Gynecologic Surgery
- Clinical Professor
- Department of Obstetrics and Gynecology
- Virginia Commonwealth University School of Medicine
Ovarian pathology can occur at any time from fetal life to menopause. The most common surgical procedures for benign ovarian disease will be reviewed here.
General principles of the evaluation and management of an adnexal mass, elective oophorectomy at the time of hysterectomy, and surgical treatment of ovarian cancer are discussed separately. (See "Approach to the patient with an adnexal mass" and "Management of an adnexal mass" and "Elective oophorectomy or ovarian conservation at the time of hysterectomy" and "Cancer of the ovary, fallopian tube, and peritoneum: Staging and initial surgical management".)
OOPHORECTOMY VERSUS CYSTECTOMY
The indications for ovarian surgery versus expectant management of an ovarian cyst depend upon the patient's age, findings on pelvic examination and ultrasound, and laboratory results. These issues are discussed in depth separately. (See "Approach to the patient with an adnexal mass" and "Differential diagnosis of the adnexal mass".)
When surgery is indicated for benign ovarian disease, preservation of ovarian tissue via cystectomy or enucleation of a solid tumor from the ovary is generally preferable to complete oophorectomy. When the ovary cannot be salvaged or insufficient viable tissue remains after attempts at conservation, oophorectomy is performed. In postmenopausal patients, no effort is made to preserve the ovary.
Indications for oophorectomy include:
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- OOPHORECTOMY VERSUS CYSTECTOMY
- ASPIRATION AND FENESTRATION VERSUS CYSTECTOMY
- SURGICAL APPROACH
- Open laparotomy versus laparoscopy
- - Use of robotic or single port laparoscopy
- - Open or laparoscopic approach
- - Laparoscopic instruments
- - Open cystectomy
- - Laparoscopic cystectomy
- POSTOPERATIVE ISSUES
- Spillage of malignant cells
- Ovarian remnant syndrome
- Fertility following unilateral oophorectomy
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS