Resection of the ovary: types, recovery, effects, pregnancy after
If the result of hormonal imbalance in women occurs an accumulation of fluid under the outer shells of the ovary – a cyst develops, or is found in malignant cells, the attending gynecologist will recommend to remove the pathological site.
Operative treatment may also be elected with polycystic ovarian syndrome, if you want to save kidney function of the patient. In all these cases, gynecologists say that we need a resection of the ovarian tissue.
What is resection of the ovary?
Is a surgical procedure in which one or both of the bodies is removed (excised) only the damaged area and the healthy tissue intact. Such an operation involves the complete removal of these reproductive glands, in most cases, a woman’s ability to conceive is preserved. Moreover, sometimes resection of the ovary is executed in order to increase the chances of pregnancy.
The intervention is performed according to the strict necessary, and only after a comprehensive survey of the woman – to minimize the risk of postoperative complications. If you wish to become pregnant after surgery may be a treatment that encourage female genital gland to the enhanced development of eggs.
The types of operations and indications for her
There are three basic types of surgical interventions on the ovaries:
- Partial resection.
- Wedge resection.
Partial resection of the ovary
It cut off part of the body. It is done to treat diseases such as:
- a single ovarian cyst, when it reaches a considerable size and do not respond to ongoing conservative treatment methods;
- dermoid cyst;
- hemorrhage in the ovarian tissue;
- pronounced inflammation of the organ, especially when it was soaked with pus;
- confirmed by prior biopsy (puncture and withdrawal of a part of unhealthy tissue) benign tumor of the ovary, for example, a cystadenoma;
- injuries, including when the preceding operation, for example, the intestine or urinary tract;
- rupture of ovarian cysts with bleeding into the abdominal cavity;
- torsion legs ovarian cysts, accompanied by severe pain;
- ectopic ovarian pregnancy is when the embryo develops on top of the body.
When polycystic ovarian resection is often done in a wedge-shaped way. Its purpose is to stimulate ovulation. It becomes possible when, during the operation from the ovary cut out a triangular (wedge-shaped) piece of tissue, whose base is directed to the capsule of the organ, which in this disease is thickened. The so-formed egg can leave the ovary to meet the sperm. The effect of such operation is stored within 6-12 months and is 84-89%.
Was recently invented another method of surgical treatment of polycystic. Instead of wedge resection has begun to perform spot the grooves in the thickened shell of the ovary that allow the egg to come out. Such destruction made in the amount of 15-25 pieces each, using a laser or electrical energy. The efficiency of this method is about 72%.
Wedge resection of the ovary is used not only to treat polycystic. Such intervention is performed and, if necessary, perform a biopsy. In this case, when the ultrasound detects dense formation in ovarian tissue, to exclude cancer, then the triangular area, which, once examined under a microscope.
Complete removal of the ovaries resection is not known. This – oophorectomy. Plan for ovarian cancer (then and fallopian tube and part of uterus removed), in case of large cysts in women after 45 years when gland abscess formed after invasive and in advanced endometriosis.
To oophorectomy can go with the original plan partial resection of the ovarian tissue – if during the operation it turned out that it is not retention cysts, and iron pseudomucinous cystoma. In the latter case, in women after the age of 40 even removed both reproductive glands – to avoid cancerous degeneration.
Resection of both ovaries will be carried out during the development of both cysts, endometrioid especially when glandular pseudomucinous cystoma. If the detected papillary cystoma, which are dangerous for their high risk of cancerous degeneration, and remove both ovaries in women of any age.
Methods of performing resection of the ovaries
Ovarian resection can be performed in two ways: laparotomies and laparoscopic.
Laparotomies excision of the organ is conducted through an incision length less than 5 cm, performed with a scalpel. Resection is performed under direct visual control using conventional tools: scalpel, clamp, tweezers.
Laparoscopic resection of the ovaries as follows. In the lower part of the abdomen is performed 3-4 cut a length of not more than 1.5 cm they inserted tubes made of medical steel – the trocar. Using one of them in the stomach is forced sterile gas (oxygen or carbon dioxide) to push the bodies apart. Through the second hole will be put camera. It will transfer the image to the screen, and it will be guided by the surgeons-gynecologists during the operation. Through the other small cuts are introduced, the tools and perform the appropriate action. After the necessary action carbon dioxide is removed, the incisions are sewn with a.
See also: Laparoscopy ovarian cysts
Preparing for the intervention
Before surgery should be carefully examined to take clinical, biochemical blood tests, to determine in it the presence of antibodies to viruses, which can reduce blood clotting (hepatitis B and C) or lower immune defenses (HIV). Also needed electrocardiogram and fluorogram.
As laparotomies and laparoscopic intervention is performed under General anesthesia, which relaxes all muscles, including between the stomach and esophagus. The contents of the stomach can be neglected in the esophagus, and from thence into the respiratory tract, which may develop pneumonia. Therefore, before surgery should stop taking food, taking food last time at 8 PM (no later), and fluid – 22:00.
In addition, you will need to cleanse the bowel: after surgery will slow down peristalsis, so it formed the stool will be absorbed into the bloodstream, poisoning the body. To avoid this, you need to perform a cleansing enema. They are made with cool water in the evening and morning before – to clean water.
How is it performed?
The intervention is performed under General anesthesia, so after getting on the operating table and the introduction of drugs into a vein woman falls asleep and ceases to feel anything.
Meanwhile, the operating gynecologist performs or one large (laparoscopiceski) or several small (laparoscopic) incisions and using instruments are the following:
- The liberation of the body and its cysts (tumors) from lying nearby organs and adhesions.
- Overlay clips on suspensory ligament of the ovary.
- The breakdown of the ovarian tissue, which is slightly higher than the pathologically changed tissue.
- Cautery or suturing the bleeding vessel.
- Suturing the remainder of the gland with absorbable thread.
- Inspection of the second ovary and pelvic.
- Check for bleeding vessels, their final closure.
- Installation of drainage (drainage) to the pelvic cavity.
- Stapling cut tissue through which the introduced tool.
Warn the patient that even with the planned laparoscopic surgery, with the case or suspected cancer or with extensive purulent inflammation or infiltration with blood, gynecologists can go to laparotomies access. In this case the life and health of the patient are put in priority over a speedy restoration of her ovary after resection, which is celebrated in laparoscopic surgery.
The consequences and the postoperative period
Conducted minimally traumatic methods (laparoscopy), with the removal of the minimum possible amount of tissue, the operation usually goes smoothly. Consequences of resection of the ovary can only be the onset of menopause soon after surgery – when you remove a lot of fabric with the two bodies, or acceleration of its occurrence – since we no longer have this fabric, which could be a new egg.
The second common effect are adhesions – adhesions between the intestine and reproductive organs. This is the second reason why you may not attack pregnancy after resection of the ovaries (the first is the removal of a large number of ovarian tissue).
They can also develop complications. This infection of the pelvic organs, hematoma, incisional hernia, internal bleeding.
Pain after resection of the ovary begin in 5-6 hours, therefore the woman in the hospital, make cauterized. Such injection continues for another 3-5 days, after which the pain should decrease. If the pain persists for more than a week, notify your doctor – it tells about the development of complications (most likely, adhesive disease).
The stitches will be removed 7-10 days. Full recovery after surgery takes 4 weeks for the laparoscopic intervention for 6-8 – when laparotomies.
After surgery observed a discharge of blood from the vagina that resembles menstruation. The intensity of the discharge should decrease, and the duration of such a reaction of the body is about 3-5 days. Month after resection of the ovaries rarely come on time. Their delay 2-21 day is considered normal. Longer lack of menstruation requires consultation with a doctor.
Ovulation after resection of the ovaries is usually observed after 2 weeks. This can be seen according to the measurement of basal temperature, or according to folliculometry (US). If your doctor has prescribed to take hormonal medicines after the surgery, its this month may not be at all, but you need to ask your gynecologist.
Can you get pregnant after resection of the ovaries?
If you have not deleted a large number of ovarian tissue. Even if the polycystic possible, and even necessary, otherwise 6-12 months chance of getting pregnant will decrease, and after 5 years and completely relapse of the disease.
Only in the first 4 weeks after surgery, sexual contacts must be excluded for proper healing of the operated tissue, and then maybe another 1-2 months will need to take hormonal contraceptives. During this period you need to pay active attention to the prevention of adhesive disease: active impellent mode, physical therapy, rich in fiber diet.
If after 6-12 months, the pregnancy does not occur, you need to go to the doctor and to exclude the possibility of tubal infertility.