Table of ContentsView AllTable of ContentsIndicationsResultsSymptoms After SurgeryPotential RisksLong-Term CareFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Indications
Results
Symptoms After Surgery
Potential Risks
Long-Term Care
Frequently Asked Questions
Bilateral salpingo-oophorectomy, also known as a BSO, is a surgical procedure in which both of theovariesand thefallopian tubesare removed. This surgery can be performed on its own, but is usually performed during ahysterectomy, in which a woman’s uterus is removed.
In contrast, when only one ovary and one fallopian tube are removed, the procedure is called a unilateral salpingo-oophorectomy. It’s sometimes designated as right or left with the acronyms “RSO” (right salpingo-oophorectomy) or “LSO” (left salpingo-oophorectomy).
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What Is a Bilateral Salpingo-Oophorectomy?
A bilateral salpingo-oophorectomy is the removal of both ovaries and fallopian tubes to treatovarian cysts, eliminate fertility, or certain types ofgynecologic cancer, especially ovarian cancer. In some cases, it may be done to preventbreast cancerandovarian cancerin women with a strong genetic risk.
Surgical Approaches
There are several surgical approaches to performing a bilateral salpingo-oophorectomy. An abdominal approach is when an incision is made into the abdomen to expose the organs. Due to the size of the incision, this approach can take a longer time to recover from and is more painful than a minimally invasive approach.
Minimally invasive approaches include the use of laparoscopy. This is when small incisions are made in the abdomen through which a tiny camera is inserted, along with instruments. The camera allows the surgeon to see inside the patient on a screen in the operating room. This is a common surgery.
A modern, minimally invasive approach is calledrobotic-assisted surgery. This is when the surgeon operates a robot from a console in the operating room to perform the surgery. With this approach, the surgeon can maximize the benefits of a smaller incision while having an increased range of motion and visualization throughout the surgery.
Results of This Surgery
When the ovaries are removed, women undergo immediate surgical menopause. This means that women who were premenopausal before surgery will now be postmenopausal, no longer having a menstrual cycle. Surgical menopause mimics what happens in natural menopause, when a woman’s estrogen levels decline with age due to a decline in ovarian function. It also means that a woman will not be able to have children.
The drop in estrogen after removal of the ovaries may also increase a woman’s risk of heart disease and osteoporosis, or bone loss—just as it does in natural menopause.
The sudden drop of estrogen in the body with surgical removal of the ovaries can make the side effects of menopause more severe, as compared to the more gradual estrogen decline seen in natural menopause. This decline in estrogen commonly produces menopausal symptoms, such as:
These symptoms may be more pronounced in premenopausal women whose ovaries were not gradually declining in estrogen production.
For premenopausal women, the immediate drop of estrogen from surgical removal of the ovaries can feel more pronounced and comes with increased health risks including:
It’s important to discuss the implications of surgically induced menopause with your healthcare provider. There are medications and treatment plans that can ease some of the symptoms following surgery.
A woman will need to follow up with her gynecologist and primary care provider after surgery to monitor health risks, like heart disease and osteoporosis, and to also determine if menopausal hormone therapy is warranted.
Menopausal hormone therapy consists of estrogen and/or progesterone, which are hormones that a woman’s ovaries make. If a woman no longer has a uterus, she can take estrogen therapy alone. Estrogen plus progesterone therapy is recommended if a woman still has her uterus. Progesterone is added to estrogen therapy to prevent estrogen from thickening the uterine lining, which can cause uterine cancer.
The decision to take menopausal hormone therapy is complex and depends on many factors like your age, symptoms, family history, medical history, and personal needs. The dose, duration, risks, and benefits of menopausal hormone therapy must be discussed carefully with your healthcare provider—it’s a decision that is unique for each woman.
Summary
Salpingo-oophorectomy is the surgical removal of both fallopian tubes and ovaries. The surgery can be performed with different surgical approaches for women who have gynecological cancer, to prevent cancer, or for sterilization purposes.
A Word From Verywell
If you’re having your fallopian tubes and ovaries surgically removed, discuss what to expect from surgical menopause with your healthcare provider. There are treatment options available to help manage the side effects.
The procedures are generally the same. The difference is that “bilateral” means both the right and left fallopian tubes and ovaries will be removed.
Total hysterectomy with bilateral salpingo-oophorectomy means surgical removal of the uterus, both fallopian tubes, and both ovaries.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The American College of Obstetricians and Gynecologists.ACOG Practice Bulletin: Hereditary breast and ovarian cancer syndrome.Mytton J, Evison F, Chilton P J, Lilford R J.Removal of all ovarian tissue versus conserving ovarian tissue at time of hysterectomy in premenopausal patients with benign disease: study using routine data and data linkage.BMJ2017; 356 :j372 doi:10.1136/bmj.j372Santoro N, Epperson CN, Mathews SB.Menopausal symptoms and their management.Endocrinol Metab Clin North Am. 2015;44(3):497–515. doi:10.1016/j.ecl.2015.05.001Secoșan C, Balint O, Pirtea L, Grigoraș D, Bălulescu L, Ilina R.Surgically Induced Menopause-A Practical Review of Literature.Medicina (Kaunas). 2019;55(8):482. doi:10.3390/medicina55080482Sarrel PM, Sullivan SD, Nelson LM.Hormone replacement therapy in young women with surgical primary ovarian insufficiency.Fertil Steril. 2016;106(7):1580–1587. doi:10.1016/j.fertnstert.2016.09.018Additional ReadingAmerican Cancer Society.Surgery for Ovarian Cancer.The North American Menopause Society.The Menopause Practice: A Clinician’s Guide, 5thed.Mayfield Heights, OH: The North American Menopause Society.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The American College of Obstetricians and Gynecologists.ACOG Practice Bulletin: Hereditary breast and ovarian cancer syndrome.Mytton J, Evison F, Chilton P J, Lilford R J.Removal of all ovarian tissue versus conserving ovarian tissue at time of hysterectomy in premenopausal patients with benign disease: study using routine data and data linkage.BMJ2017; 356 :j372 doi:10.1136/bmj.j372Santoro N, Epperson CN, Mathews SB.Menopausal symptoms and their management.Endocrinol Metab Clin North Am. 2015;44(3):497–515. doi:10.1016/j.ecl.2015.05.001Secoșan C, Balint O, Pirtea L, Grigoraș D, Bălulescu L, Ilina R.Surgically Induced Menopause-A Practical Review of Literature.Medicina (Kaunas). 2019;55(8):482. doi:10.3390/medicina55080482Sarrel PM, Sullivan SD, Nelson LM.Hormone replacement therapy in young women with surgical primary ovarian insufficiency.Fertil Steril. 2016;106(7):1580–1587. doi:10.1016/j.fertnstert.2016.09.018Additional ReadingAmerican Cancer Society.Surgery for Ovarian Cancer.The North American Menopause Society.The Menopause Practice: A Clinician’s Guide, 5thed.Mayfield Heights, OH: The North American Menopause Society.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
The American College of Obstetricians and Gynecologists.ACOG Practice Bulletin: Hereditary breast and ovarian cancer syndrome.Mytton J, Evison F, Chilton P J, Lilford R J.Removal of all ovarian tissue versus conserving ovarian tissue at time of hysterectomy in premenopausal patients with benign disease: study using routine data and data linkage.BMJ2017; 356 :j372 doi:10.1136/bmj.j372Santoro N, Epperson CN, Mathews SB.Menopausal symptoms and their management.Endocrinol Metab Clin North Am. 2015;44(3):497–515. doi:10.1016/j.ecl.2015.05.001Secoșan C, Balint O, Pirtea L, Grigoraș D, Bălulescu L, Ilina R.Surgically Induced Menopause-A Practical Review of Literature.Medicina (Kaunas). 2019;55(8):482. doi:10.3390/medicina55080482Sarrel PM, Sullivan SD, Nelson LM.Hormone replacement therapy in young women with surgical primary ovarian insufficiency.Fertil Steril. 2016;106(7):1580–1587. doi:10.1016/j.fertnstert.2016.09.018
The American College of Obstetricians and Gynecologists.ACOG Practice Bulletin: Hereditary breast and ovarian cancer syndrome.
Mytton J, Evison F, Chilton P J, Lilford R J.Removal of all ovarian tissue versus conserving ovarian tissue at time of hysterectomy in premenopausal patients with benign disease: study using routine data and data linkage.BMJ2017; 356 :j372 doi:10.1136/bmj.j372
Santoro N, Epperson CN, Mathews SB.Menopausal symptoms and their management.Endocrinol Metab Clin North Am. 2015;44(3):497–515. doi:10.1016/j.ecl.2015.05.001
Secoșan C, Balint O, Pirtea L, Grigoraș D, Bălulescu L, Ilina R.Surgically Induced Menopause-A Practical Review of Literature.Medicina (Kaunas). 2019;55(8):482. doi:10.3390/medicina55080482
Sarrel PM, Sullivan SD, Nelson LM.Hormone replacement therapy in young women with surgical primary ovarian insufficiency.Fertil Steril. 2016;106(7):1580–1587. doi:10.1016/j.fertnstert.2016.09.018
American Cancer Society.Surgery for Ovarian Cancer.The North American Menopause Society.The Menopause Practice: A Clinician’s Guide, 5thed.Mayfield Heights, OH: The North American Menopause Society.
American Cancer Society.Surgery for Ovarian Cancer.
The North American Menopause Society.The Menopause Practice: A Clinician’s Guide, 5thed.Mayfield Heights, OH: The North American Menopause Society.
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