salpingooophorectomy

Salpingooophorectomy, commonly referred to as a bilateral salpingo-oophorectomy (BSO), is the surgical removal of both ovaries and both fallopian tubes. The procedure can be performed bilaterally or unilaterally, depending on the clinical indication, with salpingooophorectomy referring to removal on both sides in most contexts.

Indications for salpingooophorectomy include prophylaxis in individuals at high genetic risk for ovarian, fallopian tube, or related cancers (for example, BRCA1 or BRCA2 mutation carriers), treatment of established ovarian or fallopian tube cancer, and management of benign gynecologic conditions such as endometriosis, persistent hydrosalpinx, or chronic pelvic pain when other options have failed. It may be performed in conjunction with hysterectomy or as a standalone procedure, depending on age, fertility desires, and cancer risk.

The operation is most commonly performed laparoscopically, using small abdominal incisions, and can be done with robotic assistance or via an open abdominal approach in certain settings. Specimens are sent to pathology for evaluation. The goal is complete removal of both ovaries and both fallopian tubes, with attention to surrounding structures such as the ureters and blood vessels.

Risks and potential complications are those of major pelvic surgery and general anesthesia, including bleeding, infection, injury to the bladder, bowel, or ureters, and complications from anesthesia. In premenopausal individuals, removal of both ovaries induces surgical menopause, with possible symptoms and long-term effects on bone density, cardiovascular risk, and sexual function. Recovery varies but often includes a hospital stay of one to several days and several weeks of convalescence.

Outcomes depend on the indication and context. In cancer, the procedure may be part of staging or cytoreduction; in prophylactic cases, it significantly lowers risk of ovarian and fallopian tube cancers, with considerations for hormone replacement therapy where appropriate.