In the event that, as a result of a hormonal disorder, a woman accumulates fluid under the outer shell of the ovary, a cyst may develop. Also, the detection of malignant cells is not ruled out. In this case, the gynecologist will recommend the removal of the pathological site. Doctors also choose an operative treatment option for polycystic ovary syndrome if it is necessary to preserve the patient's childbearing functions. In all such situations, gynecologists talk about the need for resection of the ovarian tissue. We will tell about the types of ovarian resection, indications for its implementation and the consequences of such operations below.
What is a resection?
In this case, we are talking about surgical intervention, in which only the damaged area is removed (excised) in one or both organs at once, and he althy tissue remains intact. This operation does not mean the complete removal of the reproductive glands, inTherefore, in most situations, the ability of a woman to have a child is preserved. In addition, sometimes an ovarian resection is prescribed in order to increase the chances for a woman to become pregnant.
Perform such an intervention only if necessary and only after a comprehensive examination in order to minimize the risks of postoperative complications. If you want to become pregnant immediately after the operation, a woman can be prescribed therapy that encourages the female gonads to intensively produce eggs.
Types of operation
There are only three main types of ovarian resection that are carried out today:
- Partial resection.
- Performing wedge resection.
- Oophorectomy.
Indications for partial resection
In this case, we are talking about cutting off part of the body. This operation is performed to treat the following diseases:
- The patient has a solitary ovarian cyst that reaches a significant size and does not respond to ongoing conservative treatment.
- Development of a dermoid cyst.
- Presence of hemorrhage in ovarian tissue.
- The presence of pronounced inflammation of the organ, especially when it is impregnated with pus.
- Presence of a confirmed preliminary biopsy (puncture and removal of part of the unhe althy material) of a benign ovarian tumor, for example, with cystadenoma.
- The presence of an organ injury, including due to a previous operation, which was performed, for example, on the urinary tract or on the intestines.
- Presence of a ruptured ovarian cyst with bleeding into the abdominal cavity.
- Presence of torsion of the ovarian cyst, which can be accompanied by very severe pain.
- The appearance of an ectopic ovarian pregnancy, in which the embryo develops on the organ from above.
Wedge ovarian resection and indications for it
In the presence of polycystic resection is most often performed in a wedge-shaped manner. The purpose of this operation is to stimulate ovulation. This is possible when, as part of the operation, a wedge-shaped piece of tissue is cut out of the ovary, whose base is directed to the capsule of the organ, which is thickened in this disease. Thus, the formed eggs are able to leave the ovary to meet with the sperm. The effect of a wedge ovarian resection can usually last for six to twelve months and is eighty percent.
More recently, another technique for the surgical treatment of polycystic disease has been invented. Instead of a wedge-shaped resection, dot notches are now performed, which are made on the thickened ovarian membrane. It also allows the eggs to come out. Such destructions are produced in the amount of up to twenty-five pieces each by means of laser or electrical impact. The effectiveness of this technique is seventy-two percent.
For what elseapplies?
Wedge resection of the ovary is used not only for the treatment of polycystic disease. Doctors perform such an intervention and, if necessary, perform a biopsy. In this case, when ultrasound detects any dense mass on the ovarian tissues, a triangular area is excised in the patient to rule out cancer, which is then examined under a microscope.
Indications for oophorectomy
When a complete removal of the ovaries is performed, they speak of an oophorectomy. This type of operation is planned in the presence of ovarian cancer. In this case, the fallopian tubes with part of the uterus are removed. Also, this type of operation is necessary in the presence of large cysts in women over forty-five years old, and in addition, against the background of an abscess of the gland formed immediately after an invasive intervention or against the background of widespread endometriosis.
Physicians may switch to oophorectomy after initial planning for partial resection of ovarian tissue. This can happen if during the operation it turns out that there is not a retention type of cyst, but a glandular pseudomucinous cystoma is present. In this case, in women over the age of forty, both reproductive glands are completely removed in order to avoid their cancerous degeneration.
Resection of the ovaries, among other things, is carried out with the development of both cysts in them. In the event that a papillary cystoma is found, which is dangerous with a high risk of degeneration into cancer, both ovaries are removed at once in patients of any age.
How else is ovarian resection performed?Laparoscopy is by far the most commonly used.
Laparoscopic and laparotomic resection
Resection of the ovaries can be performed by doctors in two ways, namely laparotomy or laparoscopic. Laparotomy excision of the organ is carried out through an incision with a length of at least five centimeters, which is performed with a scalpel. Doctors perform resection under visual control using conventional tools such as a clamp and tweezers.
Laparoscopic resection of an ovarian cyst is performed as follows. In the lower region of the abdomen, four incisions are made no more than one and a half centimeters long. Medical steel tubes are inserted into them along with trocars. Through one of them, a sterile gas is injected into the patient's stomach, which pushes the organs away from each other. A camera is inserted through another hole. The camera, in turn, transmits the image to the surgeons on the screen. Doctors are guided by this image during laparoscopic resection of the ovaries. Through other incisions, small instruments are introduced, with the help of which all the necessary actions are performed.
After the necessary actions and manipulations are completed, carbon dioxide is removed, and the incisions are sutured. Next, find out how ovarian resection is performed for polycystic disease.
How is the operation performed?
The intervention is usually performed under general anesthesia, in this regard, after the patient enters the operating table and the drugs are injected into her vein, she immediately falls asleep, stoppingfeel anything. In the meantime, the operating surgeon performs either one large laparotomy or a couple of small laparoscopic incisions, and with the help of tools the following is done:
- The organ and its cyst are freed from nearby adhesions.
- Clamps are placed on the ovarian suspensory ligament.
- An incision is made in the ovarian tissues, which is made slightly higher than the pathologically altered material.
- Performing cauterization or closure of bleeding vessels.
- Suturing the remaining gland with absorbable suture.
- Pelvic exam and second ovary exam.
- Checking for bleeding vessels along with final closure.
- Installation of drains in the pelvic area.
- Sewing the cut tissue through which the instrument was inserted.
The patient is warned that even in the event of a planned laparoscopic intervention, if cancer is suspected or if there is extensive purulent inflammation, as well as blood soaking, surgeons can switch to using a laparotomy approach. In this case, life along with the woman's he alth are prioritized over the faster recovery process of her ovary after the intervention, which is observed against the backdrop of laparoscopic operations.
What are the consequences of ovarian resection?
The consequences of the operation and the postoperative period
Carried out with the most gentle methods(laparoscopy) with the removal of a small amount of tissue, the operation usually goes smoothly. The main consequence of ovarian resection can only be menopause, which occurs very soon after surgery if too much ovarian tissue has been removed from both organs at once. There may also be an acceleration of the onset of menopause due to the fact that tissue has disappeared from which new eggs could form.
Many people are wondering when menstruation will begin with ovarian resection.
Another common consequence is adhesions, which are adhesions between the reproductive organs and the intestines. This is the second reason why pregnancy may not occur after ovarian resection. The development of complications is also not excluded. We are talking about infection of the pelvic organs, hematomas, postoperative hernias and internal bleeding.
As a rule, the pain after resection of the right ovary begins after six hours, in connection with which the patient, who is in the hospital, is given an anesthetic injection. Such injections are performed for another three days, after which the pain should decrease. In the event that the pain syndrome persists for more than a week, this should be notified to the doctor. Such a sign may indicate the development of complications, most likely, in this case, the matter will concern adhesive disease.
Stitches are usually removed on the seventh day. Full recovery of the patient after the operation occurs in four weeks, subject to laparoscopic intervention. Eightweeks are required to recover from laparotomy surgery. Immediately after the operation, bleeding from the vagina may be observed, which resembles menstruation. The intensity of such secretions should decrease, and the duration of this reaction of the body will take five days.
Monthly
How does my period go after ovarian resection?
Periods after surgery rarely come on time. Their delay, which lasts from two to twenty-one days, is considered normal. A longer absence of menstruation requires a mandatory consultation with a doctor.
As for ovulation after resection surgery, it is usually observed after two weeks. You can always find out about this thanks to basal temperature measurements. You can also do folliculometry. In the event that the doctor prescribes hormonal drugs after surgery, there may not be ovulation at all this month, but it is best to ask your doctor about this.
Can a woman get pregnant?
As long as too many ovarian tissues have not been removed, this is possible. Even in the presence of polycystic disease, this is quite possible, moreover, in such a case it is even necessary, otherwise, twelve months after the operation, the chances of getting pregnant will decrease to a minimum, and after five years, a relapse of this disease is completely possible.
Ovarian resection reviews
Reviews about thisoperations are inconsistent. She helped many patients get rid of polycystic disease and become pregnant. Others did not like the fact that they did not notice any effect. The desired pregnancy did not occur, the recovery period turned out to be painful, and some people developed adhesions.
