Bilateral Salpingo-Oophorectomy (BSO)

Understanding BSO: Procedure, Reasons, and Recovery

A bilateral salpingo-oophorectomy (BSO) is a surgical procedure to remove both fallopian tubes and ovaries. This surgery is often recommended for various medical reasons, including the treatment or prevention of conditions such as ovarian cancer, endometriosis, or chronic pelvic infections. Additionally, individuals with certain genetic predispositions, such as BRCA gene mutations, may undergo a BSO to significantly reduce their risk of developing ovarian or breast cancer.

The procedure is usually performed using minimally invasive techniques, such as laparoscopic surgery, which involves small incisions in the abdomen. In some cases, a larger incision may be required, depending on the patient's specific medical needs. Recovery times for a bilateral salpingo-oophorectomy can vary based on the surgical approach and individual health factors. Your healthcare team will provide personalized guidance on the recovery process and what to expect during the healing journey.

If you're considering or preparing for a bilateral salpingo-oophorectomy (BSO), understanding the procedure and its implications can help you make informed decisions about your health.

Who is a Candidate?

Women requiring removal of both fallopian tubes and ovaries for medical, preventive, or therapeutic reasons.

Common indications include:

• Ovarian or tubal cancer, or high suspicion of malignancy
• BRCA1/BRCA2 or other genetic mutations associated with high ovarian/breast cancer risk (risk-reducing surgery)
• Severe endometriosis not responding to medical therapy
• Chronic pelvic pain related to ovarian disease
• Ovarian torsion, abscesses or cysts not manageable conservatively
• Sometimes performed with hysterectomy for benign or malignant conditions.

Recovery Timeline

This is likely to vary with provider.

• Hospital stay:
  • Laparoscopic: 1–2 days
  • Open (abdominal): 3–5 days
• Return to light activities:
  • 2–4 weeks (laparoscopic)
  • 4–6 weeks (open)
• Full recovery:
  • 4–6 weeks (laparoscopic).
  • Up to 8 weeks (open).

Benefits

• Eliminates or reduces risk of ovarian and fallopian tube cancer.
• Treats underlying ovarian or tubal disease.
• Prevents recurrence of hormone-sensitive conditions (e.g. endometriosis).
• Can provide relief from chronic pelvic pain of ovarian origin.

Risks

• Surgical risks: bleeding, infection, injury to nearby organs (bowel, bladder, ureters)
• Hormonal imbalance leading to mood changes or sleep disturbances
• Adhesion formation and chronic pelvic pain in some cases.

This is just an outline. Your specialist gynaecological surgeon will be able to talk to you about these issues in more detail and make sure that there is informed consent.