Bilateral oophorectomy

Oophorectomy /ˌoʊ.əfəˈrɛktəmi/ (from Greek ᾠοφόρος, ōophóros, 'egg-bearing' + ἐκτομή, ektomḗ, 'a cutting out of') is the surgical removal of an ovary or ovaries. The surgery is also called ovariectomy, but this term is mostly used in reference to animals, e.g. the surgical removal of ovaries from laboratory animals. Removal of the ovaries of females is the biological equivalent of castration of males; the term castration is only occasionally used in the medical literature to refer to oophorectomy of women. In veterinary medicine, the removal of ovaries and uterus is called ovariohysterectomy (spaying) and is a form of sterilization. Oophorectomy /ˌoʊ.əfəˈrɛktəmi/ (from Greek ᾠοφόρος, ōophóros, 'egg-bearing' + ἐκτομή, ektomḗ, 'a cutting out of') is the surgical removal of an ovary or ovaries. The surgery is also called ovariectomy, but this term is mostly used in reference to animals, e.g. the surgical removal of ovaries from laboratory animals. Removal of the ovaries of females is the biological equivalent of castration of males; the term castration is only occasionally used in the medical literature to refer to oophorectomy of women. In veterinary medicine, the removal of ovaries and uterus is called ovariohysterectomy (spaying) and is a form of sterilization. Partial oophorectomy or ovariotomy is a term sometimes used to describe a variety of surgeries such as ovarian cyst removal, or resection of parts of the ovaries. This kind of surgery is fertility-preserving, although ovarian failure may be relatively frequent. Most of the long-term risks and consequences of oophorectomy are not or only partially present with partial oophorectomy. In humans, oophorectomy is most often performed because of diseases such as ovarian cysts or cancer; as prophylaxis to reduce the chances of developing ovarian cancer or breast cancer; or in conjunction with hysterectomy (removal of the uterus). The removal of an ovary together with the Fallopian tube is called salpingo-oophorectomy or unilateral salpingo-oophorectomy (USO). When both ovaries and both Fallopian tubes are removed, the term bilateral salpingo-oophorectomy (BSO) is used. Oophorectomy and salpingo-oophorectomy are not common forms of birth control in humans; more usual is tubal ligation, in which the Fallopian tubes are blocked but the ovaries remain intact. In many cases, surgical removal of the ovaries is performed concurrently with a hysterectomy. The formal medical name for removal of a woman's entire reproductive system (ovaries, Fallopian tubes, uterus) is 'total abdominal hysterectomy with bilateral salpingo-oophorectomy' (TAH-BSO); the more casual term for such a surgery is 'ovariohysterectomy'. 'Hysterectomy' is removal of the uterus (from the Greek ὑστέρα hystera 'womb' and εκτομία ektomia 'a cutting out of') without removal of the ovaries or Fallopian tubes. Oophorectomy for benign causes is most often performed by abdominal laparoscopy. Abdominal laparotomy or robotic surgery is used in complicated cases or when a malignancy is suspected. According to the Centers for Disease Control, 454,000 women in the United States underwent oophorectomy in 2004. The first successful operation of this type, account of which was published in the Eclectic Repertory and Analytic Review (Philadelphia) in 1817, was performed by Ephraim McDowell (1771-1830), a surgeon from Danville, Kentucky. McDowell was dubbed as the 'father of ovariotomy'. It later became known as Battey's Operation, after Robert Battey, a surgeon from Augusta, Georgia, who championed the procedure for a variety of conditions, most successfully for ovarian epilepsy. Most bilateral oophorectomies (63%) are performed without any medical indication, most (87%) were performed together with a hysterectomy. Conversely, unilateral oophorectomy is commonly performed for a medical indication (73%; cyst, endometriosis, benign tumor, inflammation, etc.) and less commonly in conjunction with hysterectomy (61%). Special indications include several groups of women with substantially increased risk of ovarian cancer, such as high-risk BRCA mutation carriers and women with endometriosis who also suffer from frequent ovarian cysts. Bilateral oophorectomy has been traditionally done in the belief that the benefit of preventing ovarian cancer would outweigh the risks associated with removal of ovaries. However, it is now clear that prophylactic oophorectomy without a reasonable medical indication decreases long-term survival rates substantially and has deleterious long-term effects on health and well-being even in post-menopausal women. The procedure has been postulated as a possible treatment method for female sex offenders.