In the event that as a result of a hormonal imbalance in a woman, fluid accumulates under the outer shell of the ovary, a cyst may develop. Also detection of malignant cells is not excluded. 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 reproductive functions. In all such situations, gynecologists talk about the need for ovarian tissue resection. We will talk about the types of ovarian resection, indications for its conduct and the consequences of such operations below.
What is a resection?
In this case, we are talking about surgical intervention, in which only one damaged area is removed (excised) in one or both organs, and healthy tissue remains intact. This operation does not mean complete removal of the reproductive glands, in this regard, in most situations, a woman’s ability to give birth to a child is preserved. In addition, sometimes ovarian resection is prescribed in order to increase the chances of a woman becoming pregnant.
Such an intervention is performed only if necessary and exclusively after a comprehensive examination in order to minimize the risks of postoperative complications. In the case of a desire to become pregnant immediately after surgery, a woman may be prescribed a therapy that helps induce the female genital glands to intensively produce eggs.
Types of operation
Allocate only three main types of ovarian resection, which are currently carried out:
- Partial resection.
- Perform wedge resection.
- Oophorectomy.
Indications for partial resection
In this case, we are talking about cutting off part of the organ. Such an operation is performed to treat the following diseases:
- The patient has a single ovarian cyst, which reaches considerable size and does not respond to conservative treatment.
- The development of a dermoid cyst.
- The presence of hemorrhage in the ovarian tissue.
- The presence of severe inflammation of the organ, especially when it is saturated with pus.
- The presence of a confirmed preliminary biopsy (puncture and removal of part of the unhealthy material) of a benign ovarian tumor, for example, with cystadenoma.
- The presence of an organ injury, including due to a previous operation, which was carried out, for example, on the urinary tract or intestines.
- The presence of rupture of an ovarian cyst with bleeding in the abdominal cavity.
- The 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.
Sphenoid resection of the ovaries and indications for it
In the presence of polycystic, resection is most often performed in a wedge-shaped manner. The purpose of such an operation is to stimulate ovulation. This is possible when, as part of the operation, a wedge-shaped piece of tissue is cut from the ovary, whose base is directed to the organ capsule, which is thickened with this disease. Thus, the formed eggs are able to leave the ovary to meet the sperm. The effect of a wedge-shaped ovarian resection, as a rule, can last for six to twelve months and is eighty percent.
More recently, another method has been invented for the surgical treatment of polycystic. Instead of a wedge-shaped resection, point notches are now performed, which are done on the thickened shell of the ovary. It also allows the eggs to exit. Such destruction is carried out in an amount of up to twenty-five pieces in each by laser or electric exposure. The effectiveness of this technique is seventy-two percent.
What else is used for?
Wedge resection of the ovary is used not only for the treatment of polycystic. Doctors perform such an intervention and, if necessary, perform a biopsy. In this case, when the ultrasound examination reveals any dense formation on ovarian tissues, a triangular section is excised from the patient to exclude cancer, which is then examined under a microscope.
Indications for oophorectomy
When the complete removal of the ovaries is carried out, they say about oophorectomy. This method 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 after forty-five years, and in addition, against the background of an abscess of the gland formed immediately after invasive intervention or against the background of widespread endometriosis.
Doctors can go on to oophorectomy against the background of the initial planning for partial resection of ovarian tissues. This can happen if during the operation it turns out that there is not a retention type of cyst, but a glandular pseudomucinous cystoma. In this case, in women after the age of forty, both reproductive glands are completely removed in order to avoid their cancerous degeneration.
Ovarian resection, 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 immediately in patients of any age.
How else do ovarian resection? Laparoscopy is the most commonly used today.
Laparoscopic and laparotomy resection
Doctors can perform ovarian resection using two methods, namely laparotomy or laparoscopic. Laparotomy of an organ is performed through an incision of at least five centimeters in length, which is performed with a scalpel. Doctors perform resection under visual inspection using conventional instruments such as a clamp and tweezers.
Laparoscopic resection of the ovarian cyst is performed as follows. In the lower abdomen, four incisions are made no more than one and a half centimeters long. They insert medical steel tubes along with trocars. Through one of them, sterile gas is injected into the patient’s stomach, which moves the organs apart. A camera is introduced through another hole. The camera, in turn, transmits a screen image to surgeons. Doctors are guided by this image during laparoscopic ovarian resection. Through other cuts, small tools are introduced with which all the necessary actions are performed.
Upon completion of the necessary actions and manipulations, carbon dioxide is removed, and the incisions are sutured. Next, we find out how ovarian resection is performed for polycystic.
How is the operation performed?
The intervention, as a rule, is performed under general anesthesia, in this regard, after the patient enters the operating table and injects drugs into her vein, she immediately falls asleep, ceasing to feel anything. Meanwhile, the operating surgeon performs either one large laparotomy, or a couple of small laparoscopic incisions, and already with the help of tools the following is carried out:
- The organ and its cyst are freed from the adhesions lying nearby.
- Clips are applied to the hanging ligament of the ovaries.
- An incision is made in the ovarian tissue, which is slightly higher than the pathologically modified material.
- Performing cauterization or suturing of bleeding vessels.
- Implementation of suturing of the remaining gland by means of absorbable suture.
- Inspection of the pelvic organs and second ovary.
- Checking for the presence of bleeding vessels along with their final suturing.
- Installation of drainage in the pelvic area.
- Stitching the cut tissue through which the instrument was inserted.
The patient is warned that even in case of a planned laparoscopic intervention in case of suspected cancer or in the presence of extensive purulent inflammation, as well as blood impregnation, surgeons can switch to the use of laparotomy access. In this case, life along with the woman’s health is given priority over the faster recovery process of her ovary after the intervention, which is observed against the background of laparoscopic operations.
What are the consequences of ovarian resection?
The consequences of the operation and the postoperative period
Carried out by 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 was removed immediately from both organs. Acceleration of the onset of menopause may also occur due to the disappearance of tissue from which new eggs could form.
Many are interested in when the menstruation begins with ovarian resection.
Another frequent consequence are 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 possible. We are talking about infection of the pelvic organs, hematomas, postoperative hernias and internal bleeding.
As a rule, pain after resection of the right ovary begins within six hours, and therefore the patient, who is in the hospital, is given an analgesic 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, notify the doctor about this. Such a sign may indicate the development of complications, most likely, in this case, it will relate to adhesive disease.
Sutures are usually removed on the seventh day. Full recovery of the patient after surgery occurs in four weeks, subject to laparoscopic intervention. Eight weeks is required to recover from a laparotomy operation. Immediately after the operation, vaginal discharge may be observed from the vagina, which resembles menstruation. The intensity of such secretions should decrease, and the duration of this body reaction will take five days.
Monthly
How are your periods after ovarian resection?
Menstruation after surgery is very rare to arrive 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, this is usually observed after two weeks. You can always find out about this thanks to the measurements of basal temperature. Folliculometry can also be performed. In the event that the doctor prescribes the administration of hormonal drugs after surgery, there may not be ovulation this month at all, but it is best to ask your doctor about this.
Can a woman get pregnant?
In the event that too many ovarian tissues have not been removed, this is possible. Even with polycystic it is quite possible, moreover, in a similar case it is even necessary, otherwise twelve months after the operation, the chances of getting pregnant will be reduced to a minimum, and after five years, a relapse of this disease is completely likely.
Ovarian resection reviews
Reviews about this operation are contradictory. She helped many patients to get rid of polycystosis 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, some formed commissures.