Our Summary

This study looks at the best way to manage the situation where a cyst on the ovary, known as an endometrioma, is accidentally found during a medical examination. This is a concern because women with these cysts have a slightly higher risk of developing ovarian cancer. The researchers wanted to know which was more cost-effective: removing the ovary with the cyst (unilateral salpingo-oophorectomy), or just keeping an eye on it (surveillance). They created a model to compare these strategies, considering factors such as cost of surgery, potential complications, cost of check-ups, and the cost of treating ovarian cancer. They also looked at the risk of dying from ovarian cancer or surgery, or from other causes related to having an ovary removed. They found that removing the ovary was associated with less deaths and less cases of ovarian cancer, even though it cost more than just monitoring the cyst. In fact, for every 40 patients who had their ovary removed, one case of ovarian cancer would be prevented, and for every 82 patients, one death would be avoided. Therefore, they concluded that removing the ovary is the preferred strategy, at least for women who aren’t planning on having children.

FAQs

  1. What is the study’s main objective regarding the management of endometrioma cysts found on the ovary?
  2. Which strategy did the study find to be more cost-effective between unilateral salpingo-oophorectomy and surveillance of the cyst?
  3. What were the significant findings of the study in terms of preventing ovarian cancer and avoiding deaths?

Doctor’s Tip

A helpful tip a doctor might tell a patient about salpingo-oophorectomy is that it may be a beneficial option for preventing ovarian cancer, especially in cases where a cyst on the ovary, such as an endometrioma, is found. The procedure may be more cost-effective in the long run and could potentially save lives by reducing the risk of developing ovarian cancer. It is important to discuss the risks and benefits with your healthcare provider to determine the best course of action for your individual situation.

Suitable For

Patients who are typically recommended salpingo-oophorectomy include those with an endometrioma, a cyst on the ovary that may increase the risk of developing ovarian cancer. Other patients who may be recommended this procedure include those with a family history of ovarian cancer, a genetic predisposition to ovarian cancer (such as BRCA mutations), or those with certain gynecological conditions such as ovarian cysts or tumors. Additionally, women who are postmenopausal or approaching menopause may also be recommended salpingo-oophorectomy as a preventive measure against ovarian cancer.

Timeline

  • Before salpingo-oophorectomy:
  1. Patient undergoes a medical examination where an endometrioma cyst on the ovary is accidentally found.
  2. Patient and healthcare provider discuss the options of unilateral salpingo-oophorectomy or surveillance.
  3. Patient may undergo further tests and consultations to determine the best course of action.
  4. Decision is made to proceed with salpingo-oophorectomy surgery.
  • After salpingo-oophorectomy:
  1. Patient undergoes the surgical procedure to remove the affected ovary.
  2. Patient may experience discomfort and pain after the surgery.
  3. Patient is monitored for any complications or side effects of the surgery.
  4. Patient may need to take time off work or limit physical activity during the recovery period.
  5. Patient may experience emotional and psychological effects of losing an ovary, especially if they were not planning on having children.
  6. Patient may need to follow up with their healthcare provider for ongoing monitoring and care.
  7. Research suggests that removing the ovary is associated with a lower risk of developing ovarian cancer and can potentially prevent cases of ovarian cancer and deaths related to the disease.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a salpingo-oophorectomy?
  2. How will removing one ovary affect my hormone levels and overall health?
  3. Are there any alternative treatment options for managing an endometrioma?
  4. How often will I need follow-up appointments or monitoring if I choose surveillance instead of surgery?
  5. What is the likelihood of developing ovarian cancer if I choose to keep the cyst under surveillance?
  6. What is the recovery process like after a salpingo-oophorectomy?
  7. Are there any long-term effects or complications associated with having an ovary removed?
  8. Will I need hormone replacement therapy after the surgery?
  9. How will this procedure impact my fertility and options for having children in the future?
  10. Are there any lifestyle changes or precautions I should take after undergoing a salpingo-oophorectomy?

Reference

Authors: Orlando MS, Cadish LA, Shepherd JP, Falcone T, Chang OH, Kho RM. Journal: Am J Obstet Gynecol. 2022 Aug;227(2):311.e1-311.e7. doi: 10.1016/j.ajog.2022.04.043. Epub 2022 Apr 28. PMID: 35490792