Salpingo-oophorectomy

FIGURE 91-1. Diagram of female reproductive tract (uterus, fallopian tubes, ovaries, vagina). Dashed-line box outlines what is removed during the total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO). 

Bilateral salpingo-oophorectomy Surgical excision (removal) of both ovaries. 

Labor and delivery - Misoprostol can induce or augment uterine contractions. A major adverse effect of the obstetrical use of misoprostol is hyperstimulation of the uterus, which may progress to uterine tetany with marked impairment of uteroplacental blood flow, uterine rupture (requiring surgical repair, hysterectomy, and/or salpingo-oophorectomy), or amniotic fluid embolism. 

Ewies AAA, Olah KSJ. Endometrial adenocarcinoma treated by hysterectomy and bilateral salpingo-oophorectomy at age 22-the dilemma of long-term HRT. J Obstet Gynaecol 2000 20 639 10. 

A laparoscopy is performed and the cysts drained. The patient is prescribed GnRh analogue plus add-back therapy. Two months later she is readmitted with left loin pain, hot, cold and dizzy symptoms. The impression is a flare-up of the endometriosis. The pain team prescribed morphine 2 hourly. Patient had radical operation subtotal abdominal hysterectomy and bilateral salpingo-oophorectomy. 

Options are medical hormonal treatments and/or surgery. Surgical treatment by laparoscopic ablation of endometriotic lesions plus adhesiolysis may improve fertility. Hormonal treatments should not be used for endometriosis in women with fertility problems as they tend to lead to ovarian suppression. Laparoscopic ablation of endometrial deposits may relieve pain in some women. Radical surgery (e.g. total abdominal hysterectomy, salpingo-oophorectomy or both) is reserved for women who have completed their family and in whom other treatments have failed. It is usually curative although... 

Patients with advanced disease should undergo a total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, node sampling, and aggressive cytoreductive surgery. However, there is ht-tle evidence that adjuvant chemotherapy or radiotherapy improves outcome. There have been no controlled stndies comparing postoperative treatment with no treatment. 

Ovarian stromal tumors normally have an indolent natnral history and rarely occur bilaterally. They are managed by nnUateral salpingo-oophorectomy and usually do not require additional treatment. Stage II stromal tumors require more extensive surgery owing to the lack of effective adjuvant therapy. Because this tumor is relatively rare, the role of chemotherapy is unclear. 

In recent years, studies of risk reducing salpingo-oophorectomy specimens from women with BRCA mutations have shown that incidentally discovered... 

Finch A, Shaw P, Rosen B, et al. Clinical and pathologic findings of prophylactic salpingo-oophorectomies in 159 BRCAl and BRCA2 carriers. Gynecol Oncol. 2006 100 58-64. 

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