Adnexectomy
Adnexectomy is a surgical procedure that involves the removal of the uterus's adnexa, that is, structures associated with the uterus – ovaries and fallopian tubes. It may involve various surgical techniques, including open surgery (laparotomy) or minimally invasive approaches such as laparoscopy. The decision about the type of approach will depend on the reason for the procedure, the general health status of the patient, as well as the experience and recommendations of the surgeon. It is important to note that adnexectomy may have significant long-term consequences, especially if the ovaries are removed, leading to a reduction in the production of female sex hormones and potentially causing an early onset of menopause.
When is it indicated?
Malignant tumors: In the case of diagnosed ovarian, fallopian tube, or peritoneal cancer. Removal of the adnexa may also be part of a broader surgical treatment for cancer. Benign masses or cysts: If benign formations are present on the ovaries or fallopian tubes that cause symptoms or have the potential to become malignant. Endometriosis: Severe cases of endometriosis involving the ovaries and/or fallopian tubes that do not respond to conservative treatments. Endometriosis can cause chronic pain and infertility. Pelvic inflammatory disease (eng.Pelvic Inflammatory Disease, PID): In severe or chronic cases of pelvic inflammatory disease that do not respond to antibiotic therapy. Prophylactic surgery: In women with a high hereditary risk of cancer, especially those with mutations in the BRCA1 or BRCA2 genes, where removal of the adnexa can significantly reduce the risk of ovarian cancer. Ovarian torsion: In rare cases of torsion (twisting) of the ovaries, which can cause ischemia and tissue necrosis. Hysterectomy for other causes: Sometimes, adnexectomy is performed as part of a hysterectomy (removal of the uterus) for various reasons, including fibroids, abnormal bleeding, or uterine prolapse.
Postoperative care
Immediate monitoring after surgery: Patients typically spend some time in the recovery unit until they recover from anesthesia. During this time, medical staff will monitor vital signs and manage pain. It is important to watch for any signs of bleeding or infection. Pain management: Anesthesiologists carefully prescribe pain relief therapy to ensure that the postoperative process is as comfortable as possible. It is common to feel pain and discomfort in the incision area. Cramping and discomfort in the abdomen are also common. Activity and rest: It is recommended to avoid heavy physical activities and lifting heavy objects during the first few weeks. Gradually increasing physical activity, including light walks, can help prevent blood clots and improve circulation. Wound care: Patients will receive instructions on how to care for the incision site, including cleaning and changing dressings. It is important to watch for signs of infection at the incision site, such as redness, swelling, pain, fever, or pus. Emotional recovery: Adnexectomy can have emotional consequences, especially if it affects fertility or leads to early menopause symptoms. Psychological support and counseling can be beneficial. Hormone replacement therapy (eng.Hormone replacement therapy, HRT): If the ovaries have been removed, HRT may be necessary to manage menopause symptoms. Follow-up appointments: Regular follow-up appointments are important to monitor recovery and address any potential complications. Each patient will have an individualized recovery plan, depending on the specifics of the surgery and her health condition.
