What is included in the patient education about salpingo-oophorectomy?

Updated: Feb 06, 2018
  • Author: Stacie M Ward, MD; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

Risks, benefits, and alternatives need to be discussed with the patient before surgery. The indication for the procedure, the patient’s medical history, age, reproductive status, and the patient’s own wishes all influence the decision on whether a surgeon attempts ovarian preservation or removal. Patients must be informed of the possible complications and the long-term effects of decreased hormone levels.

Postoperatively, patients should be educated on the typical course of recovery. Patients should be aware of signs of complications: fevers and chills, persistent nausea and vomiting, drainage from and redness of the incision, difficulty with bowel function, difficulty voiding, pain which is not resolving, chest pain, difficulty breathing, lower extremity swelling, or calf pain.

Patients should be aware of the need for long-term follow-up, especially after a bilateral salpingo-oophorectomy, to ensure proper monitoring for conditions related to a lack of hormones.

Premenopausal women who undergo a bilateral salpingo-oophorectomy may experience symptoms of surgically induced menopause, including hot flashes, night sweats, insomnia, and vaginal dryness. These patients may have the option of symptomatic relief with the use of various medications.

Options include hormone replacement with estrogen (patients who have had a hysterectomy) or estrogen and progestin combination (patients who have a uterus), antidepressants (selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors), clonidine, gabapentin, and alternative medications/herbal supplements (phytoestrogens, black cohosh, evening primrose, dong quai) [11] .

Patients need to discuss individual risks and benefits of medications and supplements to determine their best options since several factors including age, severity of symptoms, medical conditions, and breast cancer risk all influence decision making.


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