Surgery 101

Understanding the surgery itself can help you feel more prepared and better able to ask the right questions before you go into theatre.

Each procedure, whether it involves removing the ovaries or affects ovarian function, has unique implications for your hormonal health and overall well-being.

For clarity on any terms used on this page, visit our Glossary.

Types of surgery

Several gynaecological procedures can lead to surgical menopause. Those that remove the ovaries will do so immediately; others may affect the ovarian blood supply and trigger surgical menopause or bring on an early menopause.

Bilateral oophorectomy The surgical removal of both ovaries. Often performed alongside a hysterectomy but can be done as a standalone procedure. Usually laparoscopic (keyhole) but may be open surgery depending on the circumstances.
Bilateral salpingo-oophorectomy (BSO) Removal of both the ovaries and fallopian tubes.
Hysterectomy Removal of the uterus. This alone should not cause surgical menopause unless the ovaries are affected. There are three types:
- Total – uterus and cervix removed
- Subtotal – uterus removed, cervix kept
- Radical – uterus, cervix, and surrounding tissue removed, usually for cancer

Having a hysterectomy does not automatically mean your ovaries will be removed. Always ask your surgeon specifically what is planned for your ovaries and make sure this is documented.

Surgery techniques

Gynaecological surgeries are performed using different approaches. The technique used will depend on your specific procedure, your health and medical history, the size and location of the problem, and your surgeon’s expertise and the resources available.

Open surgery (laparotomy) A larger incision is made to access the abdominal cavity. Less common now but used when necessary.
Laparoscopic surgery A minimally invasive technique using small incisions and a camera. Gas is introduced into the abdomen to create space and improve visibility.
Robotic-assisted surgery A more advanced form of laparoscopic surgery using robotic systems for greater precision.
Vaginal approach The procedure is performed through the vagina, with no external incisions required.

It’s important to discuss the pros and cons of each applicable technique with your surgeon and understand which technique is planned for you, and why. They can provide insight into which method is most appropriate for your individual case, considering factors like recovery time, potential complications, and long-term outcomes.

Surgery risks

While surgical procedures have become increasingly safe, all surgery carries some risk. Common risks associated with gynaecological procedures include:

Bleeding and infection
Damage to surrounding organs and nerves
Anaesthesia complications
Blood clots
Hormonal imbalances
Adhesions and wound healing issues
Urinary or bowel changes
Changes to sexual function
Chronic pain
Emotional and psychological effects

Your healthcare team will talk you through the risks specific to your procedure and health profile before you go into surgery. Following post-operative care instructions and attending follow-up appointments are key to a safe recovery.

Before your surgery, ask your care team: Will my ovaries be removed? If so, why? What are the alternatives? What will happen to my hormones and what is the plan to manage that?