Our Summary

This research paper studies the impacts of removing one ovary (unilateral salpingo-oophorectomy or USO) in premenopausal women, in comparison to removing both ovaries (bilateral salpingo-oophorectomy or BSO). BSO is usually recommended for women who have had a hysterectomy due to gynecological cancers, or for those with genetic risk factors, especially if they do not plan to have children. However, this procedure can result in early menopause and related health risks like heart disease and osteoporosis.

The researchers studied over 42,000 women who had USO before turning 50, comparing them to over 211,000 women who did not have this procedure. They found that USO significantly reduced the risk of a serious type of ovarian cancer, but did not increase the risk of heart disease or osteoporosis. This suggests that USO might be a safer choice than BSO for premenopausal women at risk of ovarian cancer, as it doesn’t lead to early menopause and its associated health risks. However, the study did not have access to some potentially relevant data, such as certain genetic risk factors.

FAQs

  1. What is the difference between unilateral salpingo-oophorectomy (USO) and bilateral salpingo-oophorectomy (BSO)?
  2. What are the potential health risks associated with bilateral salpingo-oophorectomy (BSO)?
  3. How does undergoing a unilateral salpingo-oophorectomy (USO) affect the risk of ovarian cancer, heart disease, and osteoporosis in premenopausal women?

Doctor’s Tip

A helpful tip a doctor might tell a patient about salpingo-oophorectomy is to discuss the risks and benefits of the procedure, particularly in relation to their individual health history and risk factors. It is important to have a thorough conversation with your healthcare provider to make an informed decision about whether unilateral or bilateral salpingo-oophorectomy is the best option for you. Additionally, it is important to discuss potential hormone replacement therapy options to help manage any symptoms of early menopause that may occur after the procedure.

Suitable For

Therefore, patients who are typically recommended salpingo-oophorectomy include those with a high risk of ovarian cancer, such as those with a family history of the disease or genetic mutations like BRCA1 or BRCA2. Additionally, women who have already had a hysterectomy for gynecological cancers may also be recommended for this procedure to reduce their risk of ovarian cancer. It is important for patients to discuss the potential risks and benefits of salpingo-oophorectomy with their healthcare provider to determine the best course of action for their individual situation.

Timeline

Before Salpingo-oophorectomy:

  • Patient may experience symptoms or be diagnosed with a gynecological condition that requires the removal of one or both ovaries
  • Consultation with a gynecologist to discuss the risks and benefits of the procedure
  • Pre-operative tests and evaluations to assess the patient’s overall health and suitability for surgery
  • Surgical procedure to remove one or both ovaries, typically done through minimally invasive laparoscopic surgery
  • Post-operative recovery period, which may involve pain management, rest, and follow-up appointments with the surgeon

After Salpingo-oophorectomy:

  • Patient may experience temporary side effects such as pain, fatigue, and hormonal changes
  • Monitoring for any complications or signs of infection following the surgery
  • Long-term follow-up care to monitor hormone levels, bone density, and overall health
  • Counseling and support for any emotional or psychological impacts of the surgery, such as concerns about fertility or menopause
  • Ongoing surveillance for any potential recurrence of gynecological conditions or development of other health issues
  • Making lifestyle adjustments, such as hormone replacement therapy or dietary changes, to manage any long-term effects of ovarian removal

What to Ask Your Doctor

Some questions a patient should ask their doctor about salpingo-oophorectomy include:

  1. What are the risks and benefits of unilateral salpingo-oophorectomy versus bilateral salpingo-oophorectomy for me specifically?
  2. Will removing one ovary affect my fertility or hormone levels?
  3. How will unilateral salpingo-oophorectomy impact my risk of ovarian cancer compared to bilateral salpingo-oophorectomy?
  4. Are there any alternative treatment options or preventative measures for reducing my risk of ovarian cancer?
  5. What are the potential long-term health implications of unilateral salpingo-oophorectomy, such as early menopause or increased risk of heart disease and osteoporosis?
  6. How will unilateral salpingo-oophorectomy affect my overall quality of life and well-being?
  7. Are there any genetic tests or screenings that I should consider before making a decision about this procedure?
  8. What is the recovery process like after unilateral salpingo-oophorectomy, and what can I expect in terms of physical and emotional changes?
  9. How often will I need follow-up appointments or monitoring after undergoing unilateral salpingo-oophorectomy?
  10. Are there any lifestyle changes or medications that I should consider to manage any potential side effects or health risks associated with this procedure?

Reference

Authors: Yi H, Zhang N, Sundquist J, Sundquist K, Zheng X, Ji J. Journal: PLoS Med. 2025 Jul 7;22(7):e1004639. doi: 10.1371/journal.pmed.1004639. eCollection 2025 Jul. PMID: 40622947