This guide will help you get ready for your bilateral salpingo-oophorectomy (sal-PIN-goh-oh-oh-foh-REK-toh-mee) at Memorial Sloan Kettering (MSK). It will also help you understand what to expect during your recovery. Show
Use this guide as a source of information in the days leading up to your surgery. Bring it with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care. Back to topAbout Your SurgeryAbout your reproductive systemYour reproductive system is in your lower abdomen (belly). It includes your:
Your uterus is between your bladder and rectum. The lower narrow end of your uterus is called the cervix. Your fallopian tubes and ovaries are attached to your uterus.  Figure 1. The female reproductive system About your bilateral salpingo-oophorectomyA bilateral salpingo-oophorectomy is a surgery to remove both of your fallopian tubes and both of your ovaries. You may be having this surgery because of an ovarian cyst or a high risk of ovarian cancer. Your healthcare provider will talk with you about why you’re having it. After your surgery, you’ll stop menstruating (getting your period). You may have normal symptoms of menopause, including night sweats, hot flashes, and vaginal dryness. If you’re in menopause or have already gone through it, you may still notice some of these symptoms. Talk with your healthcare provider about ways to manage them. You’ll also be infertile (unable to have biological children) after your surgery. If you’d like to have biological children in the future, ask your healthcare provider for a referral to a fertility nurse specialist. For more information, read the resource Fertility Preservation: Options for Females Starting Cancer Treatment. The surgery you’re having is called a:
Laparoscopic or robotic-assisted laparoscopic bilateral salpingo-oophorectomyYou’ll have either a laparoscopic salpingo-oophorectomy or a robotic-assisted laparoscopic salpingo-oophorectomy. In both types of salpingo-oophorectomies, your surgeon will make a small incision (surgical cut) on your abdomen. Gas (carbon dioxide) will be pumped into your abdomen to create space. This will give your surgeon more room to do your surgery. Next, your surgeon will make several other small incisions on your abdomen. They’ll place a long, thin video camera and surgical tools through these incisions. One end will be in your abdomen and the other end will be outside your body. If you’re having a laparoscopic surgery, your healthcare provider will use their hands to control the video camera and surgical tools. If you’re having a robotic-assisted laparoscopic surgery, your surgeon will use a robot to control the camera and tools. Your surgeon will remove your ovaries through one of the small incisions, if possible. If your ovaries are too big to fit through the opening, your surgeon will make one of the incisions larger so your ovaries will fit through. Dilation and curettage (D&C)You may have a dilation and curettage (D&C) after your salpingo-oophorectomy. This procedure lets your surgeon check for abnormal cells in your uterus. During your D&C, your cervix will be dilated (opened) slightly. Your surgeon will put a tool called a curette through your cervix into your uterus. They’ll use the curette to remove a small amount of tissue from the inside of your uterus. Your surgeon may also want to look at the tissue lining the inside of your uterus to see if anything looks abnormal. This is called a hysteroscopy. During a hysteroscopy, your surgeon will put a long, thin video camera through your cervix into your uterus to examine the area. Back to topGetting Ready for Your SurgeryThis section will help you get ready for your surgery. Read it when your surgery is scheduled. Refer to it as your surgery gets closer. It has important information about what to do to get ready. As you read through this section, write down questions to ask your healthcare provider. Getting Ready for SurgeryYou and your care team will work together to get ready for your surgery. Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you’re not sure.
About Drinking AlcoholThe amount of alcohol you drink can affect you during and after your surgery. It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.
Here are things you can do before your surgery to keep from having problems:
About SmokingIf you smoke, you can have breathing problems when you have surgery. Stopping for even a few days before your surgery can help. Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling 212-610-0507. About Sleep ApneaSleep apnea is a common breathing problem. It causes you to stop breathing for short lengths of time while you’re asleep. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes fully blocked during sleep. OSA can cause serious problems during and after a procedure. Please tell us if you have or think you might have sleep apnea. If you use a breathing device (such as a CPAP machine), bring it on the day of your procedure. Using MyMSKMyMSK (my.mskcc.org) is your MSK patient portal account. You can use it to send and read messages from your care team, view your test results, see your appointment dates and times, and more. You can also invite your caregiver to make their own account so they can see information about your care. If you do not have a MyMSK account, you can sign up at my.mskcc.org. You can get an enrollment ID by calling 646-227-2593 or your doctor’s office. For help, watch How to Enroll in MyMSK: Memorial Sloan Kettering's Patient Portal. You can also contact the MyMSK Help Desk by emailing [email protected] or calling 800-248-0593. Within 30 days of your surgeryPresurgical Testing (PST)You’ll have a PST appointment before your surgery. The date, time, and location will be printed on the appointment reminder from your surgeon’s office. You can eat and take your usual medications the day of your appointment. It’s helpful to bring these things to your appointment:
During your PST appointment, you’ll meet with a nurse practitioner (NP). They work closely with anesthesiology staff (specialized healthcare providers who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You may have tests to plan your care. Examples are:
Your NP may recommend you see other healthcare providers. They’ll also talk with you about which medications to take the morning of your surgery. Identify Your CaregiverYour caregiver plays an important role in your care. Before your surgery, you and your caregiver will learn about your surgery from your healthcare providers. After your surgery, your caregiver will take you home when you’re discharged from the hospital. They’ll also help you care for yourself at home. For Caregivers Caring for a person going through cancer treatment comes with many responsibilities. MSK offers resources and support to help you manage them. For information, visit www.mskcc.org/caregivers or read A Guide for Caregivers. Complete a Health Care Proxy FormIf you have not already filled out a Health Care Proxy form, we recommend you do now. If you already filled one out or have any other advance directives, bring them to your next appointment. A health care proxy is a legal document. It says who will speak for you if you cannot communicate for yourself. This person is called your health care agent.
Do breathing and coughing exercisesPractice taking deep breaths and coughing before your surgery. Your healthcare provider will give you an incentive spirometer to help expand your lungs. For more information, read the resource How To Use Your Incentive Spirometer. ExerciseExercising will help your body get into its best condition for your surgery and make your recovery faster and easier. Try to do aerobic exercise every day. Aerobic exercise is any exercise that makes your heart beat faster, such as walking, swimming, or biking. If it’s cold outside, use stairs in your home or go to a mall or shopping center. Follow a Healthy DietFollow a well-balanced, healthy diet before your surgery. If you need help with your diet, talk with your healthcare provider about meeting with a clinical dietitian nutritionist. Buy a 4% Chlorhexidine Gluconate (CHG) Solution Antiseptic Skin Cleanser (Such As Hibiclens®)4% CHG solution is a skin cleanser that kills germs for 24 hours after you use it. Showering with it before your surgery will help lower your risk of infection after surgery. You can buy a 4% CHG solution antiseptic skin cleanser at your local pharmacy without a prescription. 7 days before your surgeryFollow Your Healthcare Provider’s Instructions for Taking AspirinIf you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Aspirin can cause bleeding. Follow your healthcare provider’s instructions. Do not stop taking aspirin unless they tell you to. For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E. Stop Taking Vitamin E, Multivitamins, Herbal Remedies, and Other Dietary SupplementsStop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before your surgery. These things can cause bleeding. If your healthcare provider gives you other instructions, follow those instead. For more information, read Herbal Remedies and Cancer Treatment. 2 days before your surgeryStop Taking Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)Stop taking NSAIDs, such as ibuprofen (Advil® and Motrin®) and naproxen (Aleve®), 2 days before your surgery. NSAIDs can cause bleeding. If your healthcare provider gives you other instructions, follow those instead. For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E. 1 day before your surgeryNote the Time of Your SurgeryA staff member from the Admitting Office will call you after 2 p.m. the day before your surgery. If your surgery is scheduled for a Monday, they’ll call you the Friday before. If you do not get a call by 7 p.m., call 212-639-5014. The staff member will tell you what time to arrive at the hospital for your surgery. They’ll also remind you where to go. Shower With a 4% CHG Solution Antiseptic Skin Cleanser (Such As Hibiclens)The night before your surgery, shower with a 4% CHG solution antiseptic skin cleanser.
Do not use any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower. Instructions for Eating Before Your Surgery The morning of your surgeryInstructions for Drinking Before Your Surgery You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else. Do not drink anything starting 2 hours before your scheduled arrival time. This includes water. Take Your Medications As InstructedA member of your care team will tell you which medications to take the morning of your surgery. Take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications. Shower With a 4% CHG Solution Antiseptic Skin Cleanser (Such As Hibiclens)Shower with a 4% CHG solution antiseptic skin cleanser before you leave for the hospital. Use it the same way you did the night before. Do not put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower. Things to remember
What to bring
Once you’re in the hospitalYou’ll be asked to say and spell your name and birth date many times. This is for your safety. People with the same or a similar name may be having surgery on the same day. When it’s time to change for surgery, you’ll get a hospital gown, robe, and nonskid socks to wear. Meet With a NurseYou’ll meet with a nurse before surgery. Tell them the dose of any medications you took after midnight and the time you took them. Make sure to include prescription and over-the-counter medications, patches, and creams. Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse does not place the IV, your anesthesiologist will do it in the operating room. Meet With an AnesthesiologistYou’ll also meet with an anesthesiologist before surgery. They will:
Your doctor or anesthesiologist may also talk with you about placing an epidural catheter (thin, flexible tube) in your spine (back). An epidural catheter is another way to give you pain medication after your surgery. Get Ready For Your SurgeryWhen it’s time for your surgery, you’ll remove your eyeglasses, hearing aids, dentures, prosthetic devices, wig, and religious articles. You’ll either walk into the operating room or a staff member will bring you there on a stretcher. A member of your care team will help you onto a bed. They will put compression boots on your lower legs. These gently inflate and deflate to help blood flow in your legs. Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV to make you fall asleep. You’ll also get fluids through your IV during and after your surgery. During your surgeryAfter you’re fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe. A urinary (Foley) catheter will also be placed to drain urine (pee) from your bladder. Once your surgery is finished, your incision will be closed with staples or sutures (stitches). You may also have Steri-Strips™ (thin pieces of surgical tape) or Dermabond® (surgical glue) over your incisions. Your incisions may be covered with a bandage. Your breathing tube is usually taken out while you’re still in the operating room. Back to topRecovering After Your SurgeryThis section will help you know what to expect after your surgery. You’ll learn how to safely recover from your surgery both in the hospital and at home. As you read through this section, write down questions to ask your healthcare provider. In the post-anesthesia care unit (PACU) or recovery roomWhen you wake up after your surgery, you’ll be in the PACU or your recovery room. A nurse will be keeping track of your body temperature, pulse, blood pressure, and oxygen levels. You may be getting oxygen through a thin tube that rests below your nose or a mask that covers your nose and mouth. You’ll also have compression boots on your lower legs. Depending on the type of surgery you had, you may stay in the PACU overnight. After your stay in the PACU, a staff member will take you to your hospital room. Soon after you arrive in your room, a staff member will help you out of bed and into a chair. Your nurse will tell you how to recover from your surgery. Below are examples of ways you can help yourself recover safely.
Commonly asked questions: During your hospital stayWill I have pain after my surgery?You may have some pain after your surgery, especially in the first few days. Your healthcare providers will ask you about your pain often and give you medication to manage your pain as needed. If your pain isn’t any better, tell one of your healthcare providers. It’s important to control your pain so you can cough, breathe deeply, use your incentive spirometer, and get out of bed and walk. What side effects can I expect after my surgery?It’s common to have some discomfort in your abdomen and shoulders after surgery. This is from the air that was pumped into your abdomen during surgery. Your discomfort should go away after a few days. Walking around can help with this. You should also drink 8 (8-ounce) glasses (2 liters) of liquids a day and make sure to take the stool softeners you received to prevent constipation. You may also have normal symptoms of menopause, such as night sweats, hot flashes, and vaginal dryness. Talk with your healthcare provider about ways to manage these symptoms. What side effects can I expect after my D&C?If you also had a D&C, you may have some vaginal spotting or light bleeding. Wear a pad or panty liner. Don’t use tampons or place anything in your vagina until your healthcare provider says it’s OK. Don’t have sexual intercourse (sex) until your healthcare provider say it’s OK. If you’re having heavy bleeding, such as bleeding through a pad every 1 to 2 hours, call your healthcare provider right away. Will I be able to eat?Yes, you’ll be able to eat a regular diet as tolerated. Start with foods that are soft and easy to digest, such as apple sauce and chicken noodle soup. Eat small meals frequently, then advance to regular foods. If you have bloating, gas, or cramps, limit high-fiber foods such as whole grain breads and cereal, nuts, seeds, salads, fresh fruit, broccoli, cabbage, and cauliflower. Commonly Asked Questions: At HomeWhat’s the Recovery Tracker?We want to know how you’re feeling after you leave the hospital. To help us continue caring for you, we’ll send questions to your MyMSK account every day for 10 days after you leave the hospital. These questions are known as your Recovery Tracker. Fill out your Recovery Tracker every day before midnight (12 a.m.). It only takes 2 to 3 minutes. Your answers to these questions will help us understand how you’re feeling and what you need. Based on your answers, we may reach out to you for more information or ask you to call your surgeon’s office. You can always contact your surgeon’s office if you have any questions. For more information, read About Your Recovery Tracker. Will I have pain when I am home?People have pain or discomfort for different lengths of time. You may still have some pain when you go home and will probably be taking pain medication. Follow these guidelines to help manage your pain at home.
Some prescription pain medications (such as opioids) may cause constipation (having fewer bowel movements than usual). How can I prevent constipation?Talk with your healthcare provider about how to prevent and manage constipation. You can also follow the guidelines below.
For more information, read the resource Constipation. Can I shower?You can shower 24 hours after your surgery. Taking a warm shower is relaxing and can help decrease muscle aches. If you have a square white bandage (Primapore® bandage) over your incision, take it off when you shower. When you shower, use soap to gently wash your incision. Pat the areas dry with a towel after showering. Leave your incision uncovered unless there’s drainage. If you have drainage, place a new bandage over your incision. Call your healthcare provider if you see any redness or drainage from your incision. Don’t take tub baths until you discuss it with your healthcare provider at your first appointment after surgery. How do I care for my incisions?You’ll have several small incisions on your abdomen. The incisions will be closed with Steri-Strips or Dermabond. You may also have square white Primapore bandages on your incisions. You can remove these in the shower 24 hours after your surgery. You should clean your incisions with soap and water. If any fluid is draining from your incisions, write down the amount and color. Call your healthcare provider’s office and tell the nurse about any drainage from your incision. If you go home with Steri-Strips on your incisions, they’ll loosen and fall off by themselves. If you go home with Dermabond on your incision, it will also loosen and peel off by itself. If the Steri-Strips and Dermabond haven’t fallen off within 10 days, you can remove them. When can I resume sexual activity?Your healthcare provider will tell you when you can resume sexual activity during your first follow-up visit after surgery. Don’t put anything in your vagina or have vaginal sex until your healthcare provider says it’s OK. When is it safe for me to drive?You can start driving again 2 weeks after surgery, as long as you aren’t taking pain medication that may make you drowsy. What exercises can I do?Doing aerobic exercise, such as walking and stair climbing, will help you gain strength and feel better. Gradually increase the distance you walk. Climb stairs slowly, resting or stopping as needed. Ask your healthcare provider before starting more demanding exercises. Will I be able to travel?Yes, you can travel. If you’re traveling by plane within a few weeks after your surgery, make sure you get up and walk every hour. Be sure to stretch your legs, drink plenty of liquids, and keep your feet elevated when possible. When can I return to work?The time it takes to return to work depends on the type of work you do, the type of surgery you had, and how fast your body heals. Most people can return to work about 2 to 4 weeks after the surgery. When can I lift heavy objects?Ask your healthcare provider when it’s safe for you to lift heavy objects after your surgery. Normally, you shouldn’t lift anything heavier than 5 to 10 pounds (2.3 to 4.5 kilograms) for at least 4 weeks after your surgery. When is my first appointment after my surgery?Your first appointment after surgery will be in 2 to 4 weeks after you leave the hospital. Your nurse will give you instructions on how to make this appointment, including the phone number to call. How can I cope with my feelings?After surgery for a serious illness, you may have new and upsetting feelings. Many people say they felt weepy, sad, worried, nervous, irritable, and angry at one time or another. You may find that you can’t control some of these feelings. If this happens, it’s a good idea to seek emotional support. The first step in coping is to talk about how you feel. Family and friends can help. Your nurse, doctor, and social worker can reassure, support, and guide you. It’s always a good idea to let these professionals know how you, your family, and your friends are feeling emotionally. Many resources are available to patients and their families. Whether you’re in the hospital or at home, the nurses, doctors, and social workers are here to help you and your family and friends handle the emotional aspects of your illness. You may also find it comforting to speak with a cancer survivor or caregiver who has been through a similar treatment. Through our Patient and Caregiver Support Program, you’re able to speak with former patients and caregivers. For more information, call 212-639-5007. Back to topWhen to Call Your Healthcare ProviderCall your healthcare provider if:
Contact informationMonday through Friday from 9:00 a.m. to 5:00 p.m., call your healthcare provider’s office. After 5:00 p.m., during the weekend, and on holidays, call 212-639-2000 and ask to speak to the person on call for your healthcare provider. Back to topSupport ServicesThis section has a list of support services. They may help you as you get ready for your surgery and recover after your surgery. As you read through this section, write down questions to ask your healthcare provider. MSK Support ServicesVisit the Cancer Types section of MSK’s website at www.mskcc.org/types for more information. Admitting Office Anesthesia Blood Donor Room Bobst International Center Caregivers
Clinic Counseling
Center Female
Sexual Medicine & Women’s Health Program Food Pantry Program Integrative Medicine
Service You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They will work with you to come up with a plan for creating a healthy lifestyle and managing side effects. To make an appointment, call 646-608-8550. Male Sexual and Reproductive Medicine Program MSK
Library Nutrition Services Patient and Caregiver Education Patient and Caregiver Peer Support
Program Patient
Billing Patient Representative Office Perioperative Nurse
Liaison Private Duty Nurses and Companions Resources for Life After Cancer (RLAC) Program This program has many services. We offer seminars, workshops, support groups, and counseling on life after treatment. We can also help with insurance and employment issues. Social
Work Our social workers can also help refer you to community agencies and programs. They also have information about financial resources, if you’re having trouble paying your bills. Spiritual Care MSK’s interfaith chapel is located near Memorial Hospital’s main lobby. It’s open 24 hours a day. If you have an emergency, call 212-639-2000. Ask for the chaplain on call. Tobacco Treatment
Program Virtual Programs Sessions are private, free, and led by experts. Visit our website for more information about Virtual Programs or to register. External support servicesAccess-A-Ride Air Charity
Network American Cancer Society (ACS) Cancer and Careers CancerCare Cancer Support Community Caregiver Action
Network Corporate Angel Network Gilda’s Club Good
Days Healthwell
Foundation Joe’s House LGBT Cancer Project LIVESTRONG Fertility
Look Good Feel Better
Program National Cancer
Institute National Cancer Legal Services Network National LGBT Cancer Network Needy Meds NYRx Partnership
for Prescription Assistance Patient Access Network Foundation Patient Advocate Foundation RxHope Educational ResourcesThis section has the educational resources mentioned in this guide. They will help you get ready for your surgery and recover after your surgery. As you read through these resources, write down questions to ask your healthcare provider.
How long does a total hysterectomy with bilateral salpingoThe procedure lasts one to three hours. The time can vary depending on the size of the uterus, and the need to take down scarring from previous surgeries, and if other tissue, such as endometrial tissue, and other organs are being removed with your uterus (like your fallopian tubes or ovaries).
What happens after a hysterectomy and ovaries are removed?If your ovaries are removed during a hysterectomy, you'll go through the menopause immediately after the operation, regardless of your age. This is known as a surgical menopause. If 1 or both of your ovaries are left intact, there's a chance you'll experience the menopause within 5 years of having your operation.
How long does it take to fully recover from a total hysterectomy?It takes about 6 to 8 weeks to fully recover after having an abdominal hysterectomy. Recovery times are often shorter after a vaginal or laparoscopy hysterectomy. During this time, you should rest as much as possible and not lift anything heavy, such as bags of shopping.
How far can I walk 2 weeks after hysterectomy?Weeks 2-4 After Hysterectomy
Most women can comfortably increase their continuous walking by approximately five minutes per week after their hysterectomy surgery. By the end of week four you may be able to walk continuously for twenty minutes.
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Total hysterectomy with bilateral salpingo oophorectomy recovery time
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